目的　探讨男性直肠癌病人在行全直肠系膜切除术 (TME)的基础上实施保留盆腔自主神经 (PANP)和保肛 ,对于减少病人术后局部复发和性功能障碍及排尿功能障碍的作用。方法　采用病例对照法 ,分析TME基础上直肠癌根治术中保留盆腔植物神经组和不保留组病人术后性功能障碍、排尿功能障碍的发生率及局部复发率。结果　研究组和对照组病人术后勃起功能障碍的发生率分别为 41.6%和 61.1% ,射精功能障碍发生率分别为 47.2 %和 69.4% ,两组比较差异有显著性 (P <0 .0 1)。局部复发率分别为 9%和 5 .6% ,差异无显著性。但吻合口瘘的发生率增高。结论　在TME基础上实施PANP ,在不增加局部复发率的情况下 ,可改善病人术后的性功能和排尿功能 ,提高病人术后的生活质量 ,应同时注意提高吻合技术 ,减少吻合口瘘的发生率 Objective To investigate the effect of preserving pelvic autonomic nerve (PANP) and anal sphincter on the basis of total mesorectal excision (TME) in male patients with rectal cancer to reduce the local recurrence, sexual dysfunction and voiding dysfunction after operation. Methods The case-control method was used to analyze the incidence of postoperative sexual dysfunction, voiding dysfunction and local recurrence in patients with preserved pelvic autonomic nerve in radical resection of rectal cancer based on TME. Results The incidence of postoperative erectile dysfunction in study group and control group were 41.6% and 61.1% respectively, and the incidences of ejaculation dysfunction were 47.2% and 69.4% respectively, with significant difference between the two groups (P <0.01) ). The local recurrence rates were 9% and 5.6% respectively, with no significant difference. However, the incidence of anastomotic leakage increased. Conclusions The implementation of PANP on the basis of TME can improve the postoperative sexual function and urinary function without increasing the local recurrence rate and improve the postoperative quality of life of patients. At the same time, we should pay attention to improving the technique of anastomosis and reducing the incidence of anastomotic fistula Occurrence rate