Autonomic nerve preservation during pelvic dissection for rectal cancer

Autonomic nerve preservation (ANP) during rectal cancer resection is based upon a comprehensive understanding of pelvic surgical anatomy and the effects of nerve injury on genitourinary dysfunction. Techniques that combine ANP with radical rectal cancer resection developed over the last 20 years have reduced the risk of sexual and bladder dysfunction without compromising oncologic results. In this article, a detailed description of the operative techniques currently employed is highlighted by comments and figures of the pertinent pelvic anatomy. The results of genitourinary function subsequent to nerve-preserving rectal cancer surgery are also presented.