Although nerve-sparing surgery has been introduced for female patients with the pelvic tumors, its success rate depends on operators. To achieve consistency of surgical procedure, It is necessary to adopt pelvic autonomic nerve monitoring technique. The Aims of this study is 1. Development of pelvic autonomic nerve monitoring system (PAMS I) by using urodynamic system. 2. Evaluation of autonomic nerve sparing by intraoperative monitoring with PAMS I 3. Evaluating the efficacy of PAMS I by intraoperative neurophysiological monitoring (IOM)
After surgery for pelvic tumor, most of patients complain voiding dysfunction, defecation dysfunction and sexual dysfunction which lead to decrease quality of life. Recently, nerve-sparing surgery has been introduced. But it is difficult to establish standard surgical procedure for nerve-sparing. And it is the concern that performing nerve sparing surgery may reduce radicality of surgery which influence prognosis. Through pelvic autonomic nerve monitoring system (PAMS I), this trial is expected to raise the possibility of nerve-sparing with maintaining radicality of surgery. Pressure sensor of PAMS I and needle prove of IOM are very thin and these instruments have been used clinically. Taking this into consideration, additional risk by nerve monitoring is considered to be minimal.
Study Type
INTERVENTIONAL
Allocation
NA
Masking
NONE
Enrollment
30
After general anesthesia, pressure sensor of PAMS I is placed into bladder, vagina and rectum. Then pressure change is monitored during performing pelvic autonomic nerve dissection. Both PAMS I and IOM will be used for monitoring.
Seoul National University Hospital
Seoul, South Korea
RECRUITINGEvaluating efficacy of PAMS I by comparison with IOM
Comparision pressure change on PAMS I with nerve conduction on IOM i) PAMS I (+) \& IOM (+): nerve-sparing ii) PAMS I (-) \& IOM (-): nerve damage iii) PAMS I (+) \& IOM (-) or PAMS I (-) \& IOM (+): intermediate
Time frame: Intraoperative
Evaluation of Quality of life.
Voiding/Defecation/Sexual function
Time frame: Preoperative, 3 months after surgery
Time period for recovering normal voiding function
Check residual urine. Keep CIC until residual urine \< 100cc
Time frame: postoperative (up to 6 month)
Urodynamic test
Time frame: Preoperative, 3 months after surgery
Anorectal manometry
Time frame: Preoperative, 3 months after surgery
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