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Langenbeck's Archives of Surgery

, Volume 390, Issue 6, pp 517–522 | Cite as

Impact of lateral pelvic lymph node dissection on evacuatory and urinary functions following low anterior resection for advanced rectal carcinoma

  • Hiroyoshi MatsuokaEmail author
  • Tadahiko Masaki
  • Masanori Sugiyama
  • Yutaka Atomi
Original Article

Abstract

Background and aim

Lateral pelvic lymph node dissection (LPLD) has been reported to be beneficial in terms of survival for locally advanced low rectal carcinoma. However, the impact of LPLD on bowel function has not yet been determined by means of anorectal physiologic investigation.

Patients and methods

Fifty-seven rectal cancer patients who underwent low anterior resection were evaluated with clinical and physiologic parameters. Of these, 15 patients had LPLD. The postoperative bowel and urinary function were evaluated with patients’ questionnaire and anorectal manometry before and after the operation.

Results

The proportion of patients who had pouch reconstruction, adjuvant radiation therapy, and autonomic nerve dissection were significantly higher in the LPLD group. The incidence of evacuatory dysfunction was significantly higher (80% vs 45%) postoperatively in the LPLD group. There was no significant difference in anal sphincter pressures, sensory threshold, and neorectal volumes between the groups postoperatively. In terms of urinary function, use of medication for urination was significantly frequent in the LPLD group. Multivariate analysis identified the level of anastomosis as an independent affecting factor for evacuatory dysfunction and LPLD for urinary dysfunction.

Conclusion

Although LPLD affected urinary dysfunction, it did not impair postoperative evacuatory function in the early postoperative period.

Keywords

Rectal cancer Lateral pelvic lymph node dissection Evacuation 

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Hiroyoshi Matsuoka
    • 1
    Email author
  • Tadahiko Masaki
    • 1
  • Masanori Sugiyama
    • 1
  • Yutaka Atomi
    • 1
  1. 1.The Department of Surgery, School of MedicineKyorin UniversityTokyoJapan

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