AI Article Synopsis
- The study examines the effectiveness of intraoperative neuromonitoring (IONM) in preserving nerve function during total mesorectal excision (TME) surgery for rectal cancer.
- It involved 150 patients, comparing outcomes between those who had IONM and those who didn't, using standardized questionnaires and measurements to assess urogenital and anorectal function.
- Results showed that patients with IONM had significantly lower rates of urinary and anorectal dysfunction post-surgery, suggesting a potential benefit, but more research is needed to confirm these findings.
Article Abstract
Aims: Intraoperative neuromonitoring (IONM) aims to control nerve-sparing total mesorectal excision (TME) for rectal cancer in order to improve patients' functional outcome. This study was designed to compare the urogenital and anorectal functional outcome of TME with and without IONM of innervation to the bladder and the internal anal sphincter.
Methods: A consecutive series of 150 patients with primary rectal cancer were analysed. Fifteen match pairs with open TME and combined urogenital and anorectal functional assessment at follow up were established identical regarding gender, tumour site, tumour stage, neoadjuvant radiotherapy and type of surgery. Urogenital and anorectal function was evaluated prospectively on the basis of self-administered standardized questionnaires, measurement of residual urine volume and longterm-catheterization rate.
Results: Newly developed urinary dysfunction after surgery was reported by 1 of 15 patients in the IONM group and by 6 of 15 in the control group (p = 0.031). Postoperative residual urine volume was significantly higher in the control group. At follow up impaired anorectal function was present in 1 of 15 patients undergoing TME with IONM and in 6 of 15 without IONM (p = 0.031). The IONM group showed a trend towards a lower rate of sexual dysfunction after surgery.
Conclusions: In this study TME with IONM was associated with significant lower rates of urinary and anorectal dysfunction. Prospective randomized trials are mandatory to evaluate the definite role of IONM in rectal cancer surgery.
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| http://dx.doi.org/10.1016/j.ejso.2013.06.004 | DOI Listing |
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