INDICATION OF SURGERY WITH AUTONOMIC NERVE PRESERVATION TECHNIQUES FOR RECTAL CANCER

Radical Surgery for rectal cancer with pelvic lymphadenectomy often causes postoperative sexual and urinary dysfunctions. In order to avoid these problems, it is necessary to adopt conservative surgical treatment of autonomic nerve presevation. However, one should be cautious about this operation, and we believe that this operation can be indicated for tumors infiltrating into the muscularis propria in the absence of lymph node metastases histologically [refer to pm (+), n (-)]. In order to know what macroscopic evaluation of progression of the tumor was comparable to this histological evaluation of pm (+) and n (-), patients with rectal cancer were investigated by using a protocol. Eighty-six cases of rectal cancer. 1) Invasion of tumors into the rectal wall 2) Lymph node metastases 3) Macroscopic evaluation of tumor progression in the cases with pm (+), n (-) 4) Histological examination in the cases with AoN (-), AoN1(+), A1N (-), A1N1 (+) 5) Survival rate A macroscopic evaluation of tumors infiltrating into the rectal wall (Ao) is agreeable with a histological evaluation (pm). A macroscopic evaluation of lymph node metastases N (-), N1 (+) turned out to be n (-) by a histological examination in most cases. The survival rate of the cases with a macroscopic evaluation of AoN (-), AoN1 (+) is comparable to the one with tumors with pm (+), n (-) as determined by a histological evaluation. In conclusion, this surgery is indicated for the cases with Ao and N (-), N1 (+) by a macroscopic evaluation.