Anus-preserving surgery with anal intersphincteric resection in the treatment of ultra-low rectal cancer
10.3760/cma.j.issn.1007-631X.2009.08.008
- VernacularTitle:内括约肌切除保肛术治疗超低位直肠癌52例临床研究
- Author:
Shiyong LI
;
Zhenjia LIANG
;
Shujun YUAN
;
Bo YU
;
Gang CHEN
;
Guang CHEN
;
Fuyi ZUO
;
Xue BAI
;
Xiaojun WEI
;
Yishi XU
;
Wei CUI
- Publication Type:Journal Article
- Keywords:
Rectal neoplasm;
Proctocolectomy,restorative;
Sphincter-preserving operation;
Inter sphincter resection
- From:
Chinese Journal of General Surgery
2009;24(8):628-630
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study clinical therapeutic effects of anus-preserving operation with resecting anal intersphincter to treat ultra-low rectal cancer through abdominal cavity. Methods We retrospectively analyzed 52 cases of ultra-low rectal cancer, with the inferior border of the cancers within 2 cm to anocutaneous line or 5 cm to the edge of anus treated by anus-preserving operation with resecting archos internal sphincter muscles through abdominal cavity and anus. There were 29 males, and 23 females, with age 28 to 76 years old, averaging 56. 3 years old. The inferior border of the cancer were within 4 cm to the edge of anus in 18 cases, including 6 cases of adenoma cancerization, and 5 cm to the anus in 34 cases. Pathologic diagnosis was well-differentiated adenocarcinoma in 21 cases, moderately differentiated in 29 cases, low differentiated in 2 cases, there were 6 cases with adenoma cancerization. 28 cases were Dukes A stage, and 24 B stage. Results The follow-up rate was 88. 4% (46/52), and the median time was 5.9 years. 2 case developed stoma leak (3.8%), and 3 developed stoma stenosis(5.7% ) after operation. The anus could roughly control defecation in 6 ～ 12 mouths after operation. The local recurrence rate was 5.7%, and the 5-year-survival rate was 72.7%. Conclusion By anus-preserving operation with resecting archos internal sphincter muscles, defecation controlling was well reserved by anus, and the 5-year-survival rate was not cut down. This operation is one of the safe and effective operations of anus-preserving procedure.
