Clinical Effect of Laparoscopic Miles and Perineal Anal Reconstruction Operation for Patients with Low Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 WEIDong , ZHANGHui , CAIJian , ZHAOTing , ZHANGYuan-yao

Anus-Colorectal Surgery Institute of PLA, The 150 th Central Hospital of PLA, Luoyang 471031, Henan Province, China;

Corresponding author：

WEIDong, Email: wd150yyw5k@yeah.net

Keywords：

Rectal cancer; Laparoscopic surgery; Perineal anal reconstruction; Clinical effect

DOI：

10.7507/1007-9424.20140325

Video：

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Objective To evaluate the safety and clinical effect of laparoscopic Miles and perineal anal recon-struction operation for patients with low rectal cancer. Methods One hundred and two patients underwent Mile's and perineal anal reconstruction operation for rectal cancer in this hospital from April 2006 to February 2010 were analyzed retrospectively, in which 58 patients underwent laparoscopic surgery (laparoscope group) and 44 patients underwent open surgery (laparotomy group).All these data such as the survival time, operative time, intraoperative blood loss, harvested lymph nodes, the first anal exhaust time and liquid diet recovery time after operation, postoperative hospitalization, and postoperative complications were collected and compared between the laparoscope group and laparotomy group. Results The demography and clinicopathologic characteristics were similar between these two groups (P > 0.05).The operation was successfully performed in all the patients.There was no death associated with the operation.Compared with the laparotomy group, the intraoperative blood loss was less (P < 0.05), the first anal exhaust time and liquid diet recovery time after operation, postoperative hospitalization were shorter (P < 0.05), the harvested lymph node was more (P < 0.05) in the laparoscope group.There were no significant differences in the operative time, postoperative complications, and the survival curves between the two groups (P > 0.05). Conclusions The clinical effects of laparoscopic and open Miles and perineal anal reconstruction operation are similar for patients with low rectal cancer.But laparoscopic operation is a safe, feasible choice with quicker recover after the operation.

Citation： WEIDong, ZHANGHui, CAIJian, ZHAOTing, ZHANGYuan-yao. Clinical Effect of Laparoscopic Miles and Perineal Anal Reconstruction Operation for Patients with Low Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(11): 1349-1352. doi: 10.7507/1007-9424.20140325 Copy

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12.	管秀雯, 甘志明, 汪晓东, 等.高龄直肠或肛管癌患者的两种极限保肛术式的术后近期结果的比较研究[J].中国普外基础与临床杂志, 2013, 22(11):1250-1256.
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1. 卫生部医政司, 结直肠癌诊疗规范专家工作组.结直肠癌诊疗规范(2010年版)[J].中华胃肠外科杂志, 2010, 13(11):865-875.
2. NCCN Clinical Practice Guidelines in Oncology-Rectal Cancer Guideline[S/EB].www.nccn.org.2011:4.
3. 高春芳, 张永军, 张东铭.肛管直肠角的作用及临床应用[J].中国临床解剖学杂志, 1989, 7(2):96-98, 127.
4. 魏东, 葛雪燕, 高春芳.直肠癌根治会阴部人工肛门重建术2600例[J].实用医药杂志, 2007, 24(5):524-525, 528.
5. Jayne DG, Thorpe HC, Copeland J, et al.Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer[J].Br J Surg, 2010, 97(11):1638-1645.
6. 池畔, 林惠铭, 卢星榕, 等.确保腹腔镜直肠系膜完全切除的手术技巧:介绍一种自创骶前隧道式分离法[J].中华胃肠外科杂志, 2009, 12(3):317-318.
7. 池畔.腹腔镜直肠癌全直肠系膜切除手术技巧[J].中华胃肠外科杂志, 2010, 13(6):397-399.
8. Kang SB, Park JW, Jeong SY, et al.Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial):short-term outcomes of an open-label randomised controlled trial[J].Lancet Oncol, 2010, 11(7):637-645.
9. Park JS, Choi GS, Jun SH, et al.Laparoscopic versus open intersphincteric resection and coloanal anastomosis for low rectal cancer:intermediate-term oncologic outcomes[J].Ann Surg, 2011, 254(6):941-946.
10. Lelong B, Bege T, Esterni B, et al.Short-term outcome after laparoscopic or open restorative mesorectal excision for rectal cancer:a comparative cohort study[J].Dis Colon Rectum, 2007, 50(2):176-183.
11. Bärlehner E, Benhidjeb T, Anders S, et al.Laparoscopic resection for rectal cancer:outcomes in 194 patients and review of the literature[J].Surg Endosc, 2005, 19(6):757-766.
12. 管秀雯, 甘志明, 汪晓东, 等.高龄直肠或肛管癌患者的两种极限保肛术式的术后近期结果的比较研究[J].中国普外基础与临床杂志, 2013, 22(11):1250-1256.
13. 梁小波, 侯生槐, 李国栋, 等.腹腔镜直肠癌手术的疗效分析[J].中华消化外科杂志, 2010, 9(6):411-414.
14. 张翔, 陈旭, 蒋雪松, 等.腹腔镜手术治疗结直肠癌[J].中华消化外科杂志, 2009, 8(5):385-386.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Effect of Laparoscopic Miles and Perineal Anal Reconstruction Operation for Patients with Low Rectal Cancer

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