학술논문
Preservation versus resection of Denonvilliers’ fascia in total mesorectal excision for male rectal cancer: follow-up analysis of the randomized PUF-01 trial
Document Type
article
Author
Jiafeng Fang; Bo Wei; Zongheng Zheng; Jian’an Xiao; Fanghai Han; Meijin Huang; Qingwen Xu; Xiaozhong Wang; Chuyuan Hong; Gongping Wang; Yongle Ju; Guoqiang Su; Haijun Deng; Jinxin Zhang; Jun Li; Xiaofeng Yang; Tufeng Chen; Yong Huang; Jianglong Huang; Jianpei Liu; Hongbo Wei; Chinese Postoperative Urogenital Function (PUF) Research Collaboration Group
Source
Nature Communications, Vol 14, Iss 1, Pp 1-9 (2023)
Subject
Language
English
ISSN
2041-1723
Abstract
Abstract Traditional total mesorectal excision (TME) for rectal cancer requires partial resection of Denonvilliers’ fascia (DVF), which leads to injury of pelvic autonomic nerve and postoperative urogenital dysfunction. It is still unclear whether entire preservation of DVF has better urogenital function and comparable oncological outcomes. We conducted a randomized clinical trial to investigate the superiority of DVF preservation over resection (NCT02435758). A total of 262 eligible male patients were randomized to Laparoscopic TME with DVF preservation (L-DVF-P group) or resection procedures (L-DVF-R group), 242 of which completed the study, including 122 cases of L-DVF-P and 120 cases of L-DVF-R. The initial analysis of the primary outcomes of urogenital function has previously been reported. Here, the updated analysis and secondary outcomes including 3-year survival (OS), 3-year disease-free survival (DFS), and recurrence rate between the two groups are reported for the modified intention-to-treat analysis, revealing no significant difference. In conclusion, L-DVF-P reveals better postoperative urogenital function and comparable oncological outcomes for male rectal cancer patients.