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ヤマグチ シゲキ
YAMAGUCHI Shigeki
山口 茂樹 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Prospective Multicenter Comprehensive Survey on Male Sexual Dysfunction following Laparoscopic, Robotic, and Transanal Approaches for Rectal Cancer (the LANDMARC Study) |
| 掲載誌名 | 正式名：Annals of surgery 略 称：Ann Surg ISSNコード：15281140/00034932 |
| 掲載区分 | 国内 |
| 巻・号・頁 | 283(5),pp.869-877 |
| 著者・共著者 | NUMATA Masakatsu, YAMAGUCHI Tomohiro, SHIOMI Akio, INADA Ryo, SHIOZAWA Manabu, KAZAMA Keisuke, HOTCHI Masanori, YAMAMOTO Daisuke, HASEGAWA Suguru, MIGUUCHI Masashi, OHNUMA Shinobu, UEHARA Kay, MUNAKATA Koji, KINUGASA Yusuke, HORIE Hisanaga, YAMAGUCHI Shigeki, TAKESHIMA Teppei, HIDA Koya, AKAGI Tomonori, KAGAWA Hiroyasu, OYAMADA Shunsuke, RINO Yasushi, SAKAI Yoshiharu, WATANABE Masahiko, NAITOH Takeshi |
| 発行年月 | 2026/05 |
| 概要 | OBJECTIVE:To investigate the incidence of male sexual dysfunction including erectile dysfunction (ErD) and ejaculatory dysfunction (EjD) after minimally invasive rectal cancer surgery.BACKGROUND:Male sexual dysfunction significantly affects after rectal cancer surgery quality of life. Current assessments using the International Index of Erectile Function-5 are unsuitable for patients with reduced postoperative sexual activity because it assume sexual intercourse. This study addresses this gap using the Erection Hardness Score and custom ejaculatory questionnaires.METHODS:This prospective multicenter open-label phase 2 trial enrolled 399 patients who underwent laparoscopic (Lap), robotic (Ro), or transanal (Ta) rectal cancer surgery. Erection Hardness Score and custom ejaculatory questionnaires assessed ErD, EjD, and potency impairment at 3, 6, and 12 months postoperatively. The rates were assessed in the full analysis set and compared between the Lap and Ro groups after propensity score matching.RESULTS:At 12 months, the overall incidences of ErD and EjD were 34.7% and 29.8%, respectively. The Ro group showed a significantly lower EjD rate (25.0%) than the Lap group (40.9%), with no significant difference in ErD. Potency impairment was lower in the Ro group at 6 months (32.7% vs 22.3%) and 12 months (29.0% vs 17.8%) postoperatively. The Ta group showed relatively high ErD and EjD at 3 months, with some recovery at 12 months.CONCLUSIONS:Minimally invasive rectal cancer surgery commonly results in ErD, EjD, and potency impairment. Ro surgery provides lower EjD rates and less potency impairment. Comprehensive sexual function assessments are essential to inform patients and improve quality of life outcomes. |
| DOI | 10.1097/SLA.0000000000006574 |
| PMID | 39435538 |