Autonomic nerve damage in rectal cancer surgery

2001 ◽  
Vol 27 (2) ◽  
pp. 124
Author(s):  
B. Moran
Keyword(s):  
Rectal Cancer ◽  
Nerve Damage ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery

scholarly journals Autonomic nerve preservation in rectal cancer surgery - the forgotten part of the TME message a practical "workshop" description for surgeons

2008 ◽  
Vol 55 (3) ◽  
pp. 11-16 ◽  
Author(s):  
B. Heald
Keyword(s):  
Rectal Cancer ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery ◽  
Autonomic Nerves ◽  
Nerve Preservation ◽  
Lateral Ligaments ◽  
Original Hypothesis ◽  
Autonomic Nerve Preservation ◽  
Cancer Spread

Conceptually TME has its basis in embryology. The original hypothesis was that cancer spread will tend, initially at least, to remain within the embryologic lymphovascular hindgut "envelope" the mesorectum and mesocolon. The corollary to the perfect specimen and cure is the perfect preservation of the layers surrounding the mesorectum which, are formed by the autonomic nerves and plexuses. The first obstacle is that few realistic photographs, sketches or diagrams have been published and visualisation and lighting low down in the pelvis is always problematic. Even when they are understood and visualised the difficulties inherent in preserving these nerves are due to the fact that they are actually adherent to the mesorectum at certain points where the dissection becomes particularly challenging. The most important and most adherent areas are the so-called "lateral ligaments" - low down laterally and anterolaterally where the inferior hypogastric plexuses (virtually the pelvic sex-brain) tether the whole mesorectal package. When the specimen has been carefully released it lifts up in a somewhat spectacular fashion - hence the old idea that there are ligaments at these points. A lesser degree of adherence may be found at various other points and particular care is required anteriorly where the nerves are converging towards the bulb of the penis with a trapezoidal septum between them - Denonvillier?s "fascia"- which is in turn adherent to the anterior mesorectum and lower down in the prostate.

scholarly journals Usefulness of Unilateral Autonomic Nerve-preserving Operation for Prevention of Urinary and Sexual Dysfunctions after Rectal Cancer Surgery.

1991 ◽  
Vol 24 (9) ◽  
pp. 2373-2378
Author(s):  
Kazutaka Yamada ◽  
Takashi Sameshima ◽  
Jun-ichiro Sameshima ◽  
Katsuro Haruyama ◽  
Shigeya Hase ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Rectal Cancer Surgery ◽  
Sexual Dysfunctions

scholarly journals Intraoperative neuromonitoring of pelvic autonomic nerves during surgigal treatment of colorectal cancer: a review of the literature and the initial experience of our clinic

2019 ◽  
Vol 18 (2) ◽  
pp. 58-64
Author(s):  
P. V. Tsarkov ◽  
V. S. Kochetkov ◽  
S. K. Efetov ◽  
Yu. E. Kitsenko ◽  
V. I. Stamov
Keyword(s):  
Rectal Cancer ◽  
Postoperative Period ◽  
Functional Outcomes ◽  
Intraoperative Neuromonitoring ◽  
Cancer Surgery ◽  
Autonomic Nerve ◽  
Nerve Plexus ◽  
Rectal Cancer Surgery ◽  
Pelvic Autonomic Nerve ◽  
Hypogastric Plexus

Introduction. Urogenital and anorectal functional disturbances associated with the pelvic autonomic nerve damage are common complications of rectal cancer surgery. the search for methods of intraoperative identification of the autonomic nerve plexus is currently one of the key tasks in modern surgery of rectal cancer. the purpose of our study is to evaluate the role of intraoperative neuromonitoring in rectal cancer surgery.Material and methods. In 2017 we performed intraoperative neuromonitoring during rectal cancer surgery in two cases. the superior hypogastric plexus and the inferior hypogastric plexus were identified and the pelvic autonomic nerve was preserved in both patients. urogenital and anorectal functional outcomes were assessed in the postoperative period.Results. Satisfactory functional outcomes in the late postoperative period and at the 12-month follow-up suggest that intraoperative neuromonitoring may be useful in identification and prevention of the pelvic autonomic nerve damage in patients with rectal cancer.Conclusion. This method would be difficult to use routinely for intraoperative identification of the autonomic nerve plexus but could be especially useful for the study of pelvic physiology. With further development, the method of intraoperative neuromonitoring could help discover a technique that will improve the surgical treatment of rectal cancer. Further research using intraoperative neuromonitoring is needed to more precisely determine its value in the preservation of urinary, anorectal and sexual function.

Impact of Specialisation in the Practice of Rectal Cancer Surgery at a District General Hospital

Endoscopy ◽  
2004 ◽  
Vol 36 (10) ◽  
Author(s):  
AL Gidwani ◽  
RS Date ◽  
D Hughes ◽  
P Neilly ◽  
R Gilliland
Keyword(s):  
Rectal Cancer ◽  
General Hospital ◽  
District General Hospital ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery
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