Objective:A meta-analysis was performed to evaluate the effects of preserving and removing denonvilliers fascia(DVF)during laparoscopic radical surgery on urination and sexual function in male patients with rectal cancer.Methods:By searching large literature databases such as Pubmed,FMRS Library,Wanfang,Weipu,CNKI,etc.,the literature search started and ended from the establishment of the database to August 2022. Meta-analysis was performed using Revman 5.3 software,and Begg's test was performed using STATA14.0 to evaluate publication bias among studies.Results:A total of 915 patients in 9 literatures were included. The experimental group retained DVF(n=457 cases)and the control group did not retain DVF(n=458 cases). The incidence of urinary dysfunction,sexual dysfunction and ejaculatory dysfunction in the experimental group was significantly lower than that in the control group,and the difference was statistically significant(Z=5.92,2.82,5.69; P<0.05),the experimental group had higher maximum urinary flow and international erectile function questionnaire scores,and the differences were statistically significant(Z=12.32,5.34; P<0.05). Sensitivity analysis was carried out after the relevant literatures were excluded one by one,and there was no significant change in the comparison of the final statistical results. The funnel plot of Begg's test indicating ejaculatory dysfunction showed no publication bias(P=0.315).Conclusion:Retention of DVF during laparoscopic radical resection of rectal cancer can effectively protect the function of pelvic autonomic nerve in male patients,so as to more effectively avoid the occurrence of postoperative urination function and sexual dysfunction.
Objective To study the subcutaneous continuous negative pressure drainage (CNPD) for the prevention of incision fat liquefaction and infection in colorectal cancer (CRC) patients with obesity undergoing open radical resection. Methods A retrospective analysis of 210 obese patients with CRC receiving radical resection in our hospital from January 2005 to June 2015 were carried out to compare incision fat liquefaction and infection rate, clearing time, hospitalization interval and incidence of postoperative intestinal obstruction between patients of CNPD (drainage group, 91 cases) and non-CNPD (non-drainage group, 119 cases). Results In drainage and non-drainage group, fat liquefaction rates were 3.3%vs 10.9%(χ2=4.236, P=0.039), the rate of incision infection were 2.2%vs 9.2%(χ2=4.408, P=0.036). The postoperative clearing time and hospitalization interval of drainage group were shorter than non-drainage group (t=2.537, 2.032, P=0.027, 0.045, respectively). The proportion of intestinal obstruction was lower in drainage group than that in non-drainage group (5.5 % vs 15.1%, χ2=4.905, P=0.027). The liquefaction rates of obese patients with diabetes mellitus were 4.0% vs 27.0% (χ2=5.421, P=0.020), and incision infection rate was 4.0%vs 24.3%(χ2=4.556, P=0.033) in two groups. Conclusions CNPD can effectively reduce incision fat liquefaction and infection rate, shorten the clearing time and hospitalization period, and may reduce the incidence of postoperative intestinal obstruction. For patients with diabetes, CNPD has obvious advantages on preventing incision fat liquefaction and infection.