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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: 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
Authors: 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
Source: BMC Urology, Vol 19, Iss 1, Pp 1-10 (2019)
Publisher Information: BMC
Publication Year: 2019
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: Genitourinary dysfunction; Injury to the pelvic autonomic nerves; Total Mesorectal excision; Rectal cancer; Diseases of the genitourinary system. Urology; RC870-923
Description: 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).
Document Type: article in journal/newspaper
Language: English
Relation: http://link.springer.com/article/10.1186/s12894-019-0501-5; https://doaj.org/toc/1471-2490; https://doaj.org/article/1a6cfd439c8546f3bc9377130ea96af9
DOI: 10.1186/s12894-019-0501-5
Availability: https://doi.org/10.1186/s12894-019-0501-5; https://doaj.org/article/1a6cfd439c8546f3bc9377130ea96af9
Accession Number: edsbas.34ACA3EA
Database: BASE