目的：评价直肠癌腹腔镜全直肠系膜切除术（TME）对患者排尿功能的影响。方法：对168 例全直肠系膜切除术患者进行回顾性分析，其中112 例行腹腔镜手术（腹腔镜组），56 例行开腹手术（开腹组），通过术后留置导尿时间、术后30 d 内尿潴留发生率、术后第7 至10 天尿流动力学指标以及术后3 个月国际前列腺症状评分（IPSS）来评价患者排尿功能。结果：两组患者术前一般资料具有可比性。腹腔镜组术后平均留置导尿时间短于开腹组（P<0.05）。尿流动力学指标检测显示，腹腔镜组最大尿流率和最大逼尿肌收缩压均高于开腹组（均P<0.05），排尿量两组无明显差异（P>0.05），腹腔镜组膀胱残余尿量少于开腹组（P<0.05）。两组术后3 个月IPSS 评分无统计学差异（P>0.05）。结论：掌握术中操作要点，腹腔镜TME 对术后短期排尿功能的影响明显小于开腹手术。
Analysis of impact of laparoscopic total mesorectal excision on urinary function
Objective: To evaluate the influence of laparoscopic total mesorectal excision (TME) on postoperative urinary function. Methods: One-hundred and sixty-eight patients undergoing TME procedure were reviewed. Of the patients, 112 cases underwent laparoscopic TME (laparoscopic group), and 56 cases were subjected to open TME (laparotomy group), and the postoperative urinary function of the patients were assessed through several aspects that included the urethral catheter indwelling time, incidence of urinary retention within 30 d after operation, urodynamic parameters on postoperative day 7 to 10, and international prostate symptom score (IPSS) at 3 months after operation. Results: The general preoperative data of the two groups were comparable. The postoperative urethral catheter indwelling time in laparoscopic group was shorter than that in laparotomy group (P<0.05). The urodynomic tests showed that peak urine flow rate and maximum detrusor pressure in laparoscopic group were higher than those in laparotomy group (both P<0.05); the voided volume of the two groups had no significant difference (P>0.05); the postvoid residual urine volume in laparoscopic group was less than that in laparotomy group (P<0.05). There was no significant difference in postoperative 3-month IPSS scores between the two groups (P>0.05). Conclusion: With a mastery of intraoperative essentials, the influence of TME on urinary function during short-term postoperative period is significantly milder after laparoscopic procedure than that exerted by laparotomy operation.