为了评估肠系膜下结直肠癌手术后高结直肠下动脉结扎对排便、尿液和性功能的影响。在进行结肠切除术时，结扎下结肠下动脉时存在较大的风险，可能会对腹主动脉前交感神经和骶前丛神经造成损伤。结肠切除术后的排便和泌尿功能障碍往往被低估和未报告。本研究是一项多中心、单盲、随机对照临床试验的二次研究。该试验涉及结直肠癌患者，接受扩展完全肠系膜切除术（e-CME）或标准肠系膜切除术（s-CME）。患者在手术前、手术后1个月和手术后1年完成问卷调查以评估排便、尿液和性功能。进行多变量分析以确定与功能障碍相关的因素。79名患者完成了手术前和手术后1年的功能评估。在高结直肠下动脉结扎的结肠切除术后1年，15.2%的患者出现轻度低位前切除综合征（LARS），12.7%的患者出现重度LARS；22.2%的男性和29.4%的女性出现尿液功能障碍；43.8%的男性和27.3%的女性出现性功能障碍。进行多变量分析后，未发现临床和手术因素与手术后1年的胃肠道或尿液功能障碍之间的显著关联。年龄被发现是两性性功能障碍的唯一相关因素（女性，β=-0.54，p=0.002；男性 β=-0.38，p=0.010）。关于康复结果，糖尿病被确定为妇女胃肠道恢复不佳（p=0.033）和尿液恢复不佳（p=0.039）的促进因素。此外，治疗组被发现与手术后1年勃起功能的恢复显著关联（p=0.046）。高结直肠下动脉结扎在结肠切除术后与较高几率的排便和泌尿功能障碍相关。年龄被发现是与结肠切除术后1年两性性功能障碍显著相关的因素。 NCT03083951临床试验亮点：•高结直肠下动脉结扎术后1年，27.9%的患者出现LARS；22.2%的男性和29.4%的女性出现尿液功能障碍；43.8%的男性和27.3%的女性出现性功能障碍。•e-CME与男性术后1年尿液功能障碍高发率相关联。然而，在多变量分析后，未发现e-CME与男性尿液功能障碍之间的关联。•年龄与术后1年两性性功能恢复相关。此外，糖尿病被确定为女性尿液功能恢复较差的因素。©2023年由作者独家许可给Springer-Verlag GmbH Germany，隶属于Springer Nature。

To assess the effect of high inferior mesenteric artery tie on defecatory, urinary, and sexual function after surgery for sigmoid colon cancer. Performing a sigmoidectomy poses a notable risk of causing injury to the preaortic sympathetic nerves during the high ligation of the inferior mesenteric artery, as well as to the superior hypogastric plexus during dissection at the level of the sacral promontory. Postoperative defecatory and genitourinary dysfunction after sigmoid colon resection are often underestimated and underreported.This study is a secondary research of a multicenter, single-blind, randomized clinical trial. The trial involved patients with sigmoid cancer who underwent either extended complete mesocolic excision (e-CME) or standard CME (s-CME). Patients completed questionnaires to assess defecatory, urinary, and sexual function before, 1 month after surgery, and 1 year after surgery. Multivariate analysis was conducted to identify factors associated with functional dysfunction.Seventy-nine patients completed functional assessments before and 1 year after surgery. One year after sigmoidectomy with a high tie of the inferior mesenteric artery, 15.2% of patients had minor low anterior resection syndrome (LARS) and 12.7% had major LARS; 22.2% of males and 29.4% of females had urinary dysfunction; and 43.8% of males and 27.3% of females had sexual dysfunction. After multivariate analysis, no significant associations were found between clinical and surgical factors and gastrointestinal or urinary dysfunction after 1 year of surgery. Age was identified as the only factor linked to sexual dysfunction in both sexes (women, β =  - 0.54, p = 0.002; men β =  - 0.38, p = 0.010). Regarding recovery outcomes, diabetes mellitus was identified as a contributing factor to suboptimal gastrointestinal recovery (p = 0.033) and urinary recovery in women (p = 0.039). Furthermore, the treatment arm was found to be significantly associated with the recovery of erectile function after 1 year of surgery (p = 0.046).A high tie of the inferior mesenteric artery during sigmoidectomy is associated with a high incidence of defecatory and genitourinary dysfunction. Age was identified as a significant factor associated with sexual dysfunction 1 year after sigmoid colon resection in both sexes.Clinical trials NCT03083951 HIGHLIGHTS: • One year after high-tie sigmoidectomy, 27.9% of patients had LARS; 22.2% of the men and 29.4% of the women had urinary dysfunction; and 43.8% of the men and 27.3% of the women had sexual dysfunction. • e-CME is associated with a high rate of urinary dysfunction in men 1 year after surgery. However, after multivariate analysis, no association was found between e-CME and urinary dysfunction in men. • Age was correlated with the recovery of sexual function in both sexes 1 year after surgery. Furthermore, diabetes mellitus was identified as the factor associated with poorer recovery of urinary function in females.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.