Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial
Abstract Background Total Mesorectal Excision (TME) is the standard surgical technique for the treatment of rectal cancer. However, rates of sexual dysfunction ofup to 50% have been described after TME, and rates of urinary dysfunction of up to 30%. Although other factors are involved, the main caus...
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| Format: | Article |
| Language: | English |
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BMC
2019-08-01
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| Series: | BMC Urology |
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| Online Access: | http://link.springer.com/article/10.1186/s12894-019-0501-5 |
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| author | Anna Pallisera-Lloveras Paula Planelles-Soler Naim Hannaoui Laura Mora-López Jesús Muñoz-Rodriguez Sheila Serra-Pla Arturo Dominguez-Garcia Joan Prats-López Salvador Navarro-Soto Xavier Serra-Aracil on behalf of Tauli-Colorectal Cancer Study Group |
| author_facet | Anna Pallisera-Lloveras Paula Planelles-Soler Naim Hannaoui Laura Mora-López Jesús Muñoz-Rodriguez Sheila Serra-Pla Arturo Dominguez-Garcia Joan Prats-López Salvador Navarro-Soto Xavier Serra-Aracil on behalf of Tauli-Colorectal Cancer Study Group |
| author_sort | Anna Pallisera-Lloveras |
| collection | DOAJ |
| description | Abstract Background Total Mesorectal Excision (TME) is the standard surgical technique for the treatment of rectal cancer. However, rates of sexual dysfunction ofup to 50% have been described after TME, and rates of urinary dysfunction of up to 30%. Although other factors are involved, the main cause of postoperative genitourinary dysfunction is intraoperative injury to the pelvic autonomic nerves. The risk is particularly high in the inferior mesenteric artery (IMA). The aim of this study is to compare pre- and post-TME sexual dysfunction, depending on the surgical approach usedin the inferior mesenteric vessels: either directly on the IMA, or from the inferior mesenteric vein (IMV) to the IMA. Methods Prospective, randomized,controlled study of patients with rectal adenocarcinoma with neoadjuvant chemoradiotherapy, who will be randomly assigned to one of two groups depending on the surgical approach to the inferior mesenteric vessels. The main variable is pre- and postoperative sexual dysfunction; secondary variables are visualization and preservation of the pelvic autonomic nerves, pre- and postoperative urinary dysfunction, and pre- and postoperative quality of life. The sample will comprise 90 patients, 45 per group. Discussion The aim is to demonstrate that the dissection route from the IMV towards the IMA favors the preservation of the pelvic autonomic nerves and thus reducesrates of sexual dysfunction post-surgery. Trial registration Ethical and Clinical Research Committee, Parc Taulí University Hospital: ID 017/315. ClinicalTrials.gov TAU-RECTALNERV-PRESERV-2018 (TRN: NCT03520088) (Date of registration 04/03/2018). |
| first_indexed | 2024-12-19T06:01:50Z |
| format | Article |
| id | doaj.art-1a6cfd439c8546f3bc9377130ea96af9 |
| institution | Directory Open Access Journal |
| issn | 1471-2490 |
| language | English |
| last_indexed | 2024-12-19T06:01:50Z |
| publishDate | 2019-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Urology |
| spelling | doaj.art-1a6cfd439c8546f3bc9377130ea96af92022-12-21T20:33:16ZengBMCBMC Urology1471-24902019-08-0119111010.1186/s12894-019-0501-5Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trialAnna Pallisera-Lloveras0Paula Planelles-Soler1Naim Hannaoui2Laura Mora-López3Jesús Muñoz-Rodriguez4Sheila Serra-Pla5Arturo Dominguez-Garcia6Joan Prats-López7Salvador Navarro-Soto8Xavier Serra-Aracil9on behalf of Tauli-Colorectal Cancer Study GroupColoproctology Unit, General and Digestive Surgery Department, Parc Taulí University Hospital, Sabadell, UniversitatAutònoma de BarcelonaUrology Department, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de BarcelonaUrology Department, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de BarcelonaColoproctology Unit, General and Digestive Surgery Department, Parc Taulí University Hospital, Sabadell, UniversitatAutònoma de BarcelonaUrology Department, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de BarcelonaColoproctology Unit, General and Digestive Surgery Department, Parc Taulí University Hospital, Sabadell, UniversitatAutònoma de BarcelonaUrology Department, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de BarcelonaUrology Department, Parc Taulí University Hospital, Sabadell, Universitat Autònoma de BarcelonaColoproctology Unit, General and Digestive Surgery Department, Parc Taulí University Hospital, Sabadell, UniversitatAutònoma de BarcelonaColoproctology Unit, General and Digestive Surgery Department, Parc Taulí University Hospital, Sabadell, UniversitatAutònoma de BarcelonaAbstract Background Total Mesorectal Excision (TME) is the standard surgical technique for the treatment of rectal cancer. However, rates of sexual dysfunction ofup to 50% have been described after TME, and rates of urinary dysfunction of up to 30%. Although other factors are involved, the main cause of postoperative genitourinary dysfunction is intraoperative injury to the pelvic autonomic nerves. The risk is particularly high in the inferior mesenteric artery (IMA). The aim of this study is to compare pre- and post-TME sexual dysfunction, depending on the surgical approach usedin the inferior mesenteric vessels: either directly on the IMA, or from the inferior mesenteric vein (IMV) to the IMA. Methods Prospective, randomized,controlled study of patients with rectal adenocarcinoma with neoadjuvant chemoradiotherapy, who will be randomly assigned to one of two groups depending on the surgical approach to the inferior mesenteric vessels. The main variable is pre- and postoperative sexual dysfunction; secondary variables are visualization and preservation of the pelvic autonomic nerves, pre- and postoperative urinary dysfunction, and pre- and postoperative quality of life. The sample will comprise 90 patients, 45 per group. Discussion The aim is to demonstrate that the dissection route from the IMV towards the IMA favors the preservation of the pelvic autonomic nerves and thus reducesrates of sexual dysfunction post-surgery. Trial registration Ethical and Clinical Research Committee, Parc Taulí University Hospital: ID 017/315. ClinicalTrials.gov TAU-RECTALNERV-PRESERV-2018 (TRN: NCT03520088) (Date of registration 04/03/2018).http://link.springer.com/article/10.1186/s12894-019-0501-5Genitourinary dysfunctionInjury to the pelvic autonomic nervesTotal Mesorectal excisionRectal cancer |
| spellingShingle | Anna Pallisera-Lloveras Paula Planelles-Soler Naim Hannaoui Laura Mora-López Jesús Muñoz-Rodriguez Sheila Serra-Pla Arturo Dominguez-Garcia Joan Prats-López Salvador Navarro-Soto Xavier Serra-Aracil on behalf of Tauli-Colorectal Cancer Study Group Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial BMC Urology Genitourinary dysfunction Injury to the pelvic autonomic nerves Total Mesorectal excision Rectal cancer |
| title | Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial |
| title_full | Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial |
| title_fullStr | Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial |
| title_full_unstemmed | Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial |
| title_short | Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery: a randomized controlled trial |
| title_sort | dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery a randomized controlled trial |
| topic | Genitourinary dysfunction Injury to the pelvic autonomic nerves Total Mesorectal excision Rectal cancer |
| url | http://link.springer.com/article/10.1186/s12894-019-0501-5 |
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