Evidence map›Paper›PMID 41168470›Full record

ArticleSurgical endoscopy2026

Risk factors for male sexual dysfunction after minimally invasive surgery for rectal cancer: a multicenter prospective subanalysis of the LANDMARC study.

Tsubasa Sakurai, Tomohiro Yamaguchi, Masakatsu Numata, Takashi Sakamoto, Koya Hida, Tomonori Akagi, Akio Shiomi, Ryo Inada, Manabu Shiozawa, Keisuke Kazama and 19 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Tsubasa SakuraiDepartment of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.
Tomohiro YamaguchiDepartment of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan. tyamaguchi-ncd@umin.ac.jp.ORCID 0000-0002-5023-0985
Masakatsu NumataDepartment of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Kanagawa, Japan.
Takashi SakamotoDepartment of Gastroenterological Surgery, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.
Koya HidaDepartment of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Tomonori AkagiDepartment of Gastroenterological and Pediatric Surgery, Faculty of Medicine, Oita University, Oita, Japan.
Akio ShiomiDivision of Colon and Rectal Surgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan.
Ryo InadaDepartment of Gastroenterological Surgery, Kochi Health Sciences Center, Kochi, Japan.
Manabu ShiozawaDepartment of Gastroenterological Surgery, Kanagawa Cancer Center, Kanagawa, Japan.
Keisuke KazamaDepartment of Surgery, Yokohama City University, Kanagawa, Japan.
Masanori HotchiDepartment of Surgery, Ehime Prefectural Central Hospital, Ehime, Japan.
Daisuke YamamotoDepartment of Gastroenterological Surgery, Ishikawa Prefectural Central Hospital, Ishikawa, Japan.
Suguru HasegawaDepartment of Gastroenterological Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
Masashi MiguchiDepartment of Gastroenterological Surgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
Shinobu OhnumaDepartment of Surgery, Tohoku University Graduate School of Medicine, Miyagi, Japan.
Kay UeharaDepartment of Gastrointestinal Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan.
Koji MunakataDepartment of Surgery, Ikeda City Hospital, Osaka, Japan.
Hisanaga HorieDepartment of Surgery, Jichi Medical University, Tochigi, Japan.
Toru MiyakeDepartment of Surgery, Shiga University of Medical Science, Shiga, Japan.
Hiroki TakahashiDepartment of Gastroenterological Surgery, Graduate School of Medical Sciences, Nagoya City University, Aichi, Japan.
Akinobu FurutaniDepartment of Gastroenterological Surgery, Hyogo Cancer Center, Hyogo, Japan.
Shuichiro MatobaDepartment of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan.
Kazuhiro SakamotoDepartment of Coloproctological Surgery, Faculty of Medicine, Juntendo University, Tokyo, Japan.
Hiroyasu KagawaDepartment of Gastrointestinal Surgery, Institute of Science Tokyo, Tokyo, Japan.
Yusuke KinugasaDepartment of Gastrointestinal Surgery, Institute of Science Tokyo, Tokyo, Japan.
Shigeki YamaguchiDivision of Colorectal Surgery, Department of Surgery, Tokyo Women's Medical University, Tokyo, Japan.
Masahiko WatanabeDepartment of Surgery, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Takeshi NaitohDepartment of Lower Gastrointestinal Surgery, Kitasato University School of Medicine, Kanagawa, Japan.
LANDMARC Collaborative Study Group of the Japan Society of Laparoscopic Colorectal Surgery

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSexual dysfunction (SD) is a recognized complication of rectal cancer surgery, even minimally invasive surgery (MIS), and can significantly impact postoperative quality of life. This study aimed to identify risk factors for SD and develop a predictive nomogram in a multicenter prospective setting.

methodsThis sub-analysis of the LANDMARC study initially enrolled 399 male patients who underwent laparoscopic (Lap) or robotic (Ro) rectal cancer surgery at 49 Japanese institutions between December 2019 and October 2022. After excluding patients who underwent transanal total mesorectal excision, total pelvic exenteration, prostate or seminal vesicle resection, surgical conversion, preoperative SD, or incomplete SD assessment, 300 patients were included in the final analysis. SD was defined as the presence of either erectile dysfunction or ejaculation dysfunction at 12 months postoperatively based on patient-reported questionnaires.

resultsSD was observed in 129 (43.0%) patients. Multivariate analysis identified advanced age (odds ratio [OR]: 1.041; p = 0.01) and the Lap approach (compared with Ro surgery; OR: 1.795; p = 0.02) as independent risk factors for SD. A nomogram was constructed using variables selected by Least Absolute Shrinkage and Selection Operator regression. The model demonstrated modest discriminative ability (area under the curve: 0.672) with reasonable calibration in the intermediate-risk group.

conclusionsAdvanced age and Lap surgery were associated with an increased risk of postoperative SD after MIS for rectal cancer. Therefore, Ro surgery may offer protective advantages. Although the predictive accuracy of the nomogram was limited, it may aid preoperative counseling and raise awareness of postoperative sexual outcomes.

Indexed as

Erectile DysfunctionLaparoscopyPostoperative ComplicationsRectal NeoplasmsRobotic Surgical ProceduresSexual Dysfunction, PhysiologicalAgedAge FactorsHumansJapanMaleMiddle AgedNomogramsProspective StudiesQuality of LifeRisk FactorsMinimally invasive surgeryNomogramPredictionRectal cancerSexual dysfunction

Identifiers

PMID41168470

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.