ArticleSurgical endoscopy2016
Electrophysiology-based quality assurance of nerve-sparing in laparoscopic rectal cancer surgery: Is it worth the effort?
Article in Surgical endoscopy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Intraoperative neuromonitoring in rectal cancer surgery: a systematic review and meta-analysis.International journal of colorectal disease · 2021Pooled it
- Surgeons' assessment of internal anal sphincter nerve supply during TaTME - inbetween expectations and reality.Minimally invasive therapy & allied technologies : MITAT : official journal of the Society for Minimally Invasive Therapy · 2016Trial
- Low anterior resection syndrome: can it be prevented?International journal of colorectal disease · 2021Review
- Optimising functional outcomes in rectal cancer surgery.Langenbeck's archives of surgery · 2021Review
- Novel multi-image view for neuromapping meets the needs of the robotic surgeon.Techniques in coloproctology · 2018Article
- Sexual dysfunction following rectal cancer surgery.International journal of colorectal disease · 2017Review
- Risk Factor Analysis for Newly Developed Urogenital Dysfunction after Total Mesorectal Excision and Impact of Pelvic Intraoperative Neuromonitoring-a Prospective 2-Year Follow-Up Study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Article
- Nerve-sparing surgery and sexual and urinary dysfunction after multimodality treatment for rectal cancer.Techniques in coloproctology · 2017Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAfter low anterior resection for rectal cancer, visual assessment of pelvic autonomic nerve preservation can be difficult due to the complexity of neuroanatomy, as well as surgery- and patient-related factors. The present study aimed to evaluate nerve-sparing quality assurance using the laparoscopic neuromapping (LNM) technique.
methodsWe prospectively investigated a series of 30 patients undergoing laparoscopic low anterior resection. Nerve-sparing was evaluated both visually and electrophysiologically. LNM was performed using stimulation of pelvic autonomic nerves under simultaneous cystomanometry and processed electromyography of the internal anal sphincter. Urogenital and anorectal functions were evaluated using validated and standardized questionnaires preoperatively, at short-term follow-up, and at mid-term follow-up at a median of 9 months (range 6-12 months) after surgery.
resultsOne patient reported new onset of urinary dysfunction, and another patient reported new onset of anorectal dysfunction. Of the 20 sexually active patients, five reported sexual dysfunction. Visual assessment by laparoscopy confirmed complete nerve preservation in 28 of 30 cases. For prediction of urinary and anorectal function, LNM sensitivity, specificity, positive and negative predictive value, and overall accuracy were each 100 %. LNM with combined assessment for prediction of sexual function yielded a sensitivity of 80 %, specificity of 93 %, positive predictive value of 80 %, negative predictive value of 93 %, and overall accuracy of 90 %.
conclusionsLNM is an appropriate method for reliable quality assurance of laparoscopic nerve-sparing.
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