{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:15:24Z","timestamp":1788434124815,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Using data from the LANDMARC study, we aimed to evaluate the impacts of abdominoperineal resection (APR) on postoperative sexual function in males with rectal cancer undergoing minimally invasive surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients were categorized into the APR (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200944) and anal\u2010sparing surgery (AS) groups (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009329). A detailed subgroup analysis was performed in patients with tumors located &lt;\u20095\u2009cm from the anal verge (APR,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200939; AS,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200959). Sexual function was assessed preoperatively and at 3, 6, and 12\u2009months postoperatively using the International Index of Erectile Function\u20105 (IIEF\u20105), Erection Hardness Score (EHS), and a customized questionnaire for ejaculatory function. Propensity score\u2013based logistic regression models and longitudinal analyses were applied to address significant baseline imbalances.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In the overall cohort, APR was independently associated with significantly impaired erectile function. Adjusted models showed higher predicted probabilities of erectile dysfunction (ErD) after APR at 3\u2009months (38.7% vs. 16.8) and 12\u2009months (34.7% vs. 13.7%). Longitudinal analyses confirmed increased odds of ErD at 3\u2009months (OR 2.86; 95% CI 1.25\u20136.53) and 12\u2009months (OR 3.05; 95% CI 1.30\u20137.14). Potency impairment was also significantly more frequent at 3\u2009months. Ejaculatory dysfunction was more common after APR early postoperatively. In patients with tumors located &lt;\u20095\u2009cm from the anal verge, APR remained associated with impaired erectile function, whereas ejaculatory function showed partial recovery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Results suggest that APR is associated with a high risk of postoperative sexual dysfunction, even in minimally invasive surgery. Sexual function preservation is an important consideration when APR is considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70171","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T07:37:07Z","timestamp":1768030627000},"page":"1051-1065","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Abdominoperineal Resection on Postoperative Male Sexual Function After Minimally Invasive Rectal Cancer Surgery: A Subgroup Analysis From the\n                    <scp>LANDMARC<\/scp>\n                    Study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2532-5368","authenticated-orcid":false,"given":"Taiki","family":"Kajiwara","sequence":"first","affiliation":[{"name":"Department of Surgery Tohoku University Graduate School of Medicine  Sendai Miyagi 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