Study on the Necessity of Autonomic Nerve Protection in 4K Laparoscopic Radical Surgery for Rectal Cancer
HUANG Yuanzhe
ZHANG Dingxi
ZOU Haoyang
Abstract：Objective To investigate the necessity of autonomic nerve protection in 4K laparoscopic radical surgery for rectal cancer.Methods A total of 98 patients who underwent 4K laparoscopic radical surgery for rectal cancer in the Department of General Surgery Ⅱ at Xuchang People's Hospital from June 2022 to June 2023 were selected.They were divided into two groups based on whether autonomic nerve protection was performed during surgery:the autonomic nerve protection group and the non-autonomic nerve protection group,with 49 cases in each group.The perioperative indicators,anorectal dynamic indicators,oxidative stress indicators,levels of inflammatory factors,immune function indicators,incidence of postoperative complications,and the incidence rates of urination,erectile,and ejaculation dysfunction were compared between the two groups.Results The intraoperative blood loss,number of bowel movements at 2 weeks and 6 months postoperatively in the autonomic nerve protection group were less than those in the non-autonomic nerve protection group.The duration of surgery,recovery of bowel function,and hospital stay were shorter in the autonomic nerve protection group than in the non-autonomic nerve protection group,with statistically significant differences(P<0.05).After surgery,the anorectal inhibitory response threshold(AIRT)in the autonomic nerve protection group was lower than that in the non-autonomic nerve protection group.The anal resting pressure(ARP),maximum systolic pressure(MSP),rectal resting pressure(RRP),high-pressure zone length(HPZ),and maximum rectal tolerance capacity(MTV)were higher than those in the non-autonomic nerve protection group,and the differences were statistically significant(P<0.05).After surgery,the serum inflammatory factor levels of patients in the autonomic nerve protection group were lower than those in the non-autonomic nerve protection group,and the differences were statistically significant(P<0.05).Postoperatively,the levels of serum superoxide dismutase(SOD)and cluster of differentiation(CD)4+and the CD4+/CD8+ratio in the autonomic nerve protection group were higher than those in the non-autonomic nerve protection group,while the levels of serum malondialdehyde(MDA)and CD8+were lower,with statistically significant differences(P<0.05).The incidence of postoperative complications,as well as the incidence rates of urination,erectile,and ejaculation dysfunction in the autonomic nerve protection group,were lower than those in the non-autonomic nerve protection group,with statistically significant differences(P<0.05).Conclusion In 4K laparoscopic radical resection of rectal cancer,if conditions permit,priority should be given to protecting the patient's autonomic nerve.
Keywords：Rectal Cancer4K Laparoscopic Radical SurgeryAutonomic Nerve Protection
Publication Date：2024-09-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 25-29 )