As the incidence of colorectal cancer (CRC) increases among younger adults, the need for discussions regarding treatment-related infertility is growing. The negative impacts of gonadotoxic chemotherapy and pelvic radiation are well documented, but the role that surgical intervention for CRC plays in infertility is less clear. Additionally, treatment-related infertility counseling occurs infrequently. This review provides an overview of the connection between abdominal and pelvic surgery on male and female infertility and elucidates the role of surgeons in counseling to alleviate psychological distress in newly diagnosed patients. A review of the literature revealed that pelvic surgery leads to increased adhesion formation, which is known to be associated with female infertility. Furthermore, nerve damage from pelvic surgery has significant implications for ejaculatory issues in males and sexual dysfunction in both males and females, which ultimately impact pregnancy success. Patients have significant distress related to treatment-related infertility, and pre-treatment fertility counseling has been shown to alleviate some of this psychological burden. Nevertheless, many patients do not receive counseling, particularly in surgical clinics, despite surgeons often being the first providers to see newly diagnosed non-metastatic patients. Efforts should be made to enact protocols that ensure fertility conversations are being had with patients in surgical clinics and that patients are being referred to fertility specialists appropriately. This patient-centered approach will lessen the psychological burden placed on patients during a vulnerable time in their lives.
随着结直肠癌（CRC）在年轻群体中的发病率不断上升，关于治疗相关不孕问题的讨论需求日益增长。性腺毒性化疗和盆腔放疗的负面影响已有充分记录，但结直肠癌手术治疗对不孕的影响尚不明确。此外，治疗相关的不孕咨询开展频率较低。本综述概述了腹部及盆腔手术与男女性不孕之间的关联，并阐明了外科医生在咨询中缓解新确诊患者心理困扰的作用。文献回顾显示，盆腔手术会增加粘连形成，而粘连已知与女性不孕相关。此外，盆腔手术造成的神经损伤对男性射精功能障碍及两性性功能障碍具有显著影响，最终影响妊娠成功率。患者对治疗相关不孕问题存在显著心理困扰，而治疗前的生育咨询已被证明能缓解部分心理负担。然而，尽管外科医生通常是首诊新确诊非转移性患者的医疗提供者，许多患者仍未获得咨询，尤其在外科门诊中。应着力制定规范，确保在外科门诊与患者进行生育问题沟通，并将患者适时转诊至生育专科医生。这种以患者为中心的方法将减轻患者在其生命脆弱时期所承受的心理负担。
Fertility Concerns Related to Surgery for Colorectal Cancer: An Under-Discussed Topic
肿瘤(癌症)患者之家