关键词: 直肠癌, 邓氏筋膜, 全直肠系膜切除, 泌尿功能, 勃起功能

Abstract: Objective To explore the application effect of improved total mesorectal excision (TME) with complete preservation of Deng’s fascia in rectal cancer. Methods Ninety-five patients with rectal cancer who were treated in our hospital from June 2019 to May 2021 were selected as the study subjects,and they were divided into iTME group(50 cases) and TME group(45 cases) according to different surgical methods.Among them,patients in iTME group received TME surgery with complete preservation of Deng’s fascia,and patients in TME group received general TME surgery.The patients were followed up for 12 months,and their data were collected to compare the recent surgical efficacy,urinary function and erectile function of the two groups. Results There was no significant difference between the two groups in sex ratio,age,BMI,preoperative radio and chemotherapy ratio,distance between tumor and anal margin,whether diabetes mellitus was combined,intraoperative bleeding volume and postoperative recovery time (P>0.05),while the operation time in iTME group was longer than that in TME group (P<0.05).Comparing the postoperative urinary function of patients in the two groups,it was found that there were no severe symptoms in the iTME group,2 patients with moderate symptoms (4.00%).2 patients with severe symptoms (4.44%) and 9 patients with moderate symptoms (20.00%) in the TME group.There was a significant difference between the two groups in urinary function (P<0.05).After comparing the erectile function of male patients in the two groups,it was found that in the iTME group,1 patient with severe erectile dysfunction (3.45%),1 patient with moderate erectile dysfunction (3.45%),12 patients with mild erectile dysfunction (41.38%).2 patients with severe erectile dysfunction (8.00%),3 patients with moderate erectile dysfunction (12.00%),and 11 patients with mild erectile dysfunction (44.00%) were found in the TME group,but there was no significant difference between the two groups in erectile function (P>0.05). Conclusion The improved innovative TME with complete preservation of Deng’s fascia can bring better curative effect to patients on the basis of ensuring safety,and at the same time,reduce the damage to patients’ urinary function and male erectile function

Key words: rectal cancer, denonvilliers fascia, total mesorectal excision, urinary function, erectile function