Introduction to Rectal Cancer and the Importance of Nerve Preservation
Main Article Content
Abstract
Introduction: Rectal cancer is an increasingly common and worrying disease that affects the rectum, the terminal part of the large intestine. Early detection and treatment are crucial to improving patient outcomes.
Methods: We conducted a narrative review of the scientific literature to examine nerve preservation in rectal cancer surgery. Previous studies were analyzed and relevant findings related to the preservation of autonomic and pelvic nerves, as well as the prevention of sphincter dysfunction, were identified.
Results: Rectal surgeries may be associated with various complications, which can have a significant impact on patients' quality of life. The preservation of the autonomic and pelvic nerves plays a crucial role in reducing postoperative urinary and sexual dysfunction. Studies have shown that nerve-sparing surgical techniques improve functional outcomes and patient satisfaction.
Discussion: Nerve preservation in rectal cancer surgery requires a meticulous surgical approach and a thorough understanding of the anatomical structures involved. By preserving nerve function, not only urinary and sexual function are improved, but also overall quality of life. In addition, nerve preservation plays a critical role in preventing sphincter dysfunction after pelvic exenteration surgery.
Conclusions: The preservation of autonomic and pelvic nerves in rectal cancer surgery is essential to minimize complications and improve patients' quality of life. Proper patient selection and compliance with oncology criteria contribute to the preservation of sphincter function without compromising survival rates. Preoperative radiation therapy may also increase the likelihood of sphincter sparing in patients with rectal cancer
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Hajri A, Fatine A, Eddaoudi Y, et al. Epidemiology, incidence and treatment of rectal cancer in young women case serie about 11 cases (case series). Ann Med Surg 2012. 2022;82:104693.
doi:10.1016/j.amsu.2022.104693
II. Riss S, Mittlböck M, Riss K, Chitsabesan P, Stift A. Intraoperative complications have a negative impact on postoperative outcomes after rectal cancer surgery. Int J Surg Lond Engl. 2014;12(8):833-836. doi:10.1016/j.ijsu.2014.07.003
III. Shearer R, Gale M, Aly OE, Aly EH. Have early postoperative complications from laparoscopic rectal cancer surgery improved over the past 20 years? Colorectal Dis Off J Assoc Coloproctology G B Irel. 2013;15(10):1211-1226.
doi:10.1111/codi.12302
IV. Singh J, Stift A, Brus S, Kosma K, Mittlböck M, Riss S. Rectal cancer surgery in older people does not increase postoperative complications--a retrospective analysis. World J Surg Oncol. 2014;12:355. doi:10.1186/1477-7819-12-355
V. Kwaan MR, Fan Y, Jarosek S, Elliott SP. Long-term Risk of Urinary Adverse Events in Curatively Treated Patients With Rectal Cancer: A Population-Based Analysis. Dis Colon Rectum. 2017;60(7):682-690.
doi:10.1097/DCR.0000000000000788
VI. Di Cristofaro L, Ruffolo C, Pinto E, et al. Complications after surgery for colorectal cancer affect quality of life and surgeon-patient relationship. Colorectal Dis Off J Assoc Coloproctology G B Irel. 2014;16(12):O407-419. doi:10.1111/codi.12752
VII. van Kooten RT, Elske van den Akker-Marle M, Putter H, et al. The Impact of Postoperative Complications on Short- and Long-Term Health-Related Quality of Life After Total Mesorectal Excision for Rectal Cancer. Clin Colorectal Cancer. 2022;21(4):325-338. doi:10.1016/j.clcc.2022.07.004
VIII. Del Río C, Sánchez-Santos R, Oreja V, et al. Long-term urinary dysfunction after rectal cancer surgery. Colorectal Dis Off J Assoc Coloproctology G B Irel. 2004;6(3):198-202.
doi:10.1111/j.1463-1318.2004.00624.x
IX. Forner DM, Lampe B. Intestinal complications after pelvic exenterations in gynecologic oncology. Int J Gynecol Cancer Off J Int Gynecol Cancer Soc. 2009;19(5):958-962. doi:10.1111/IGC.0b013e3181a3f77c
X. Maas CP, Moriya Y, Steup WH, Klein Kranenbarg E, van de Velde CJ. A prospective study on radical and nerve-preserving surgery for rectal cancer in the Netherlands. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2000;26(8):751-757. doi:10.1053/ejso.2000.0998
XI. Ameda K, Kakizaki H, Koyanagi T, Hirakawa K, Kusumi T, Hosokawa M. The long-term voiding function and sexual function after pelvic nerve-sparing radical surgery for rectal cancer. Int J Urol Off J Jpn Urol Assoc. 2005;12(3):256-263. doi:10.1111/j.1442-2042.2005.01026.x
XII. Burch J, Taylor C, Wilson A, Norton C. Symptoms affecting quality of life after sphincter-saving rectal cancer surgery: A systematic review. Eur J Oncol Nurs Off J Eur Oncol Nurs Soc. 2021;52:101934. doi:10.1016/j.ejon.2021.101934
XIII. Luo BJ, Zheng MC, Xia Y, et al. Assessment of defecation function after sphincter-saving resection for mid to low rectal cancer: A cross-sectional study. Eur J Oncol Nurs Off J Eur Oncol Nurs Soc. 2021;55:102059.
doi:10.1016/j.ejon.2021.102059
XIV. Poletto AHO, Lopes A, Carvalho AL, et al. Pelvic exenteration and sphincter preservation: an analysis of 96 cases. J Surg Oncol. 2004;86(3):122-127. doi:10.1002/jso.20063
XV. Paquette IM, Kemp JA, Finlayson SRG. Patient and hospital factors associated with use of sphincter-sparing surgery for rectal cancer. Dis Colon Rectum. 2010;53(2):115-120. doi:10.1007/DCR.0b013e3181bc98a1
XVI. Howard JH, Gonzalez Q, Arnoletti JP, et al. Prognostic factors and preoperative radiation therapy associated with sphincter preservation in patients with resectable rectal cancer. Am J Surg. 2008;195(2):239-243. doi:10.1016/j.amjsurg.2007.03.011
XVII. Bujko K, Nowacki MP, Oledzki J, Sopyło R, Skoczylas J, Chwaliński M. Sphincter preservation after short-term preoperative radiotherapy for low rectal cancer--presentation of own data and a literature review. Acta Oncol Stockh Swed. 2001;40(5):593-601. doi:10.1080/028418601750444132
XVIII. Kim DW, Lim SB, Kim DY, et al. Pre-operative chemo-radiotherapy improves the sphincter preservation rate in patients with rectal cancer located within 3 cm of the anal verge. Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2006;32(2):162-167. doi:10.1016/j.ejso.2005.10.002
XIX. Provenzale D, Gray RN. Colorectal cancer screening and treatment: review of outcomes research. J Natl Cancer Inst Monogr. 2004;(33):45-55. doi:10.1093/jncimonographs/lgh005
XX. Luca F, Craigg DK, Senthil M, et al. Sexual and urinary outcomes in robotic rectal surgery: review of the literature and technical considerations. Updat Surg. 2018;70(3):415-421. doi:10.1007/s13304-018-0581-x
XXI. Fukunaga Y, Higashino M, Tanimura S, et al. Laparoscopic mesorectal excision with preservation of the pelvic autonomic nerves for rectal cancer. Hepatogastroenterology. 2007;54(73):85-90.
XXII. Liu Y, Lu XM, Tao KX, et al. Anatomical basis and clinical research of pelvic autonomic nerve preservation with laparoscopic radical resection for rectal cancer. J Huazhong Univ Sci Technol Med Sci Hua Zhong Ke Ji Xue Xue Bao Yi Xue Ying Wen Ban Huazhong Keji Daxue Xuebao Yixue Yingdewen Ban. 2016;36(2):211-214. doi:10.1007/s11596-016-1568-9
XXIII. Liang X, Hou S, Liu H, et al. Effectiveness and safety of laparoscopic resection versus open surgery in patients with rectal cancer: a randomized, controlled trial from China. J Laparoendosc Adv Surg Tech A. 2011;21(5):381-385. doi:10.1089/lap.2010.0059
XXIV. Rachinger J, Rampp S, Prell J, Scheller C, Alfieri A, Strauss C. Tumor origin and hearing preservation in vestibular schwannoma surgery. J Neurosurg. 2011;115(5):900-905. doi:10.3171/2011.7.JNS102092
XXV. Jain VK, Mehrotra N, Sahu RN, Behari S, Banerji D, Chhabra DK. Surgery of vestibular schwannomas: an institutional experience. Neurol India. 2005;53(1):41-45; discussion 45. doi:10.4103/0028-3886.15052
XXVI. Romiyo P, Ng E, Dejam D, et al. Radiosurgery treatment is associated with improved facial nerve preservation versus repeat resection in recurrent vestibular schwannomas. Acta Neurochir (Wien). 2019;161(7):1449-1456. doi:10.1007/s00701-019-03940-2
XXVII. Dong X shu, Xu H tao, Li Z gao, Liu F, Xing J. [Effect of lateral lymph nodes dissection and autonomic nerve preservation in anterior resection for rectal cancer: 124 cases review]. Zhonghua Wai Ke Za Zhi. 2007;45(17):1164-1166.
XXVIII. Liang JT, Lai HS, Lee PH, Chang KJ. Laparoscopic pelvic autonomic nerve-preserving surgery for sigmoid colon cancer. Ann Surg Oncol. 2008;15(6):1609-1616.
doi:10.1245/s10434-008-9861-x
XXIX. Huang H, Ji L, Gu Y, Li Y, Xu S. Efficacy and Safety of Sphincter-Preserving Surgery in the Treatment of Complex Anal Fistula: A Network Meta-Analysis. Front Surg. 2022;9:825166.
doi:10.3389/fsurg.2022.825166
XXX. Lee DK, Jo MK, Song K, Park JW, Moon SM. Voiding and sexual function after autonomic-nerve-preserving surgery for rectal cancer in disease-free male patients. Korean J Urol. 2010;51(12):858-862. doi:10.4111/kju.2010.51.12.858
XXXI. Luca F, Valvo M, Ghezzi TL, et al. Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer. Ann Surg. 2013;257(4):672-678. doi:10.1097/SLA.0b013e318269d03b
XXXII. Vaccaro CA, Yazyi FJ, Ojra Quintana G, et al. Locally advanced rectal cancer: Preliminary results of rectal preservation after neoadjuvant chemoradiotherapy. Cirugia Espanola. 2016;94(5):274-279.
doi:10.1016/j.ciresp.2015.12.007
XXXIII. Araujo SEA, Seid VE, Klajner S. Robotic surgery for rectal cancer: current immediate clinical and oncological outcomes. World J Gastroenterol. 2014;20(39):14359-14370. doi:10.3748/wjg.v20.i39.14359
XXXIV. Ansari SA, Javed MA, Hedayat F, Harris C, Gill M, Sheikh A. Real-world comparison of curative open, laparoscopic and robotic resections for sigmoid and rectal cancer-single center experience. J Robot Surg. 2022;16(2):315-321.
doi:10.1007/s11701-021-01239-y
XXXV. Scarpinata R, Aly EH. Does robotic rectal cancer surgery offer improved early postoperative outcomes? Dis Colon Rectum. 2013;56(2):253-262.
doi:10.1097/DCR.0b013e3182694595
XXXVI. Awawda M, Taha T, Salman S, Billan S, Hijab A. The evolving treatment paradigm of locally advanced rectal cancer: a narrative review. J Gastrointest Oncol. 2022;13(4):2033-2047. doi:10.21037/jgo-22-13