Clinical observation of laparoscopic abdominoperineal intersphincteric resection com-bined with ileostomy for treatment of ultra-low rectal cancer
10.3969/j.issn.1000-8179.2019.03.263
- VernacularTitle:腹腔镜经括约肌间切除联合回肠预防性造口治疗超低位直肠癌的疗效观察
- Author:
Jinghui QU
1
;
Jiabei HE
;
Qi ZHANG
;
Shanchen LI
;
Dianchao CHEN
;
Xiangdong YANG
Author Information
1. ①四川洲际胃肠肛门病医院/成都肛肠专科医院草金院区结直肠外科(成都市610045)
- Keywords:
ultra-low rectal cancer;
abdominoperanal intersphincteric resection;
laparoscopy;
ileostomy
- From:
Chinese Journal of Clinical Oncology
2019;46(3):122-125
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To observe and evaluate the clinical efficacy of laparoscopic abdominoperineal intersphincteric resection com-bined with ileostomy for the treatment of ultra-low rectal cancer. Methods: Clinicopathologic data of 74 patients undergoing laparo-scopic radical resection for ultra-low rectal cancer at Coloproctology Hospital of Chengdu from January 2015 to June 2017 were retro-spectively analyzed. In total, 43 patients underwent laparoscopic abdominoperineal intersphincteric resection combined with ileosto-my (ISR group), and 31 patients underwent laparoscopic low anterior resection combined with ileostomy (LAR group). The periopera-tive condition, radical resection of tumor, and postoperative anal function were compared between the two groups. Results: There were no significant differences in blood loss, postoperative hospital stay, and postoperative complications between the groups (all P>0.05). The mean operative time was (306.6 ± 25.1) minutes in the ISR group and (239.7 ± 26.4) minutes in the LAR group (P=0.010). There were no significant differences in pT and pN between the groups (all P values>0.05). The coincidence rate of T stage diagnosis was 93.0% in the ISR group and 93.5% in the LAR group. The positive rate of circumferential resection margin in the two groups was 0. The mean distance of the distal margin was (2.3±0.1) cm in the ISR group and (1.4±0.3) cm in the LAR group (P<0.001). All patients were followed up for 12-42 (mean 23.4) months. The local recurrence rate was 0 in the ISR group and 12.9% (4/31) in the LAR group (P=0.027); no distant metastasis was observed in any of the groups. There was no significant difference in the results of the anorectal manometry test between the groups (P>0.05). The proportion of patients with good continence of anal function after closure of ileos- tomy was 83.7% in the ISR group and 87.1% in the LAR group (P>0.05). Conclusions: Laparoscopic abdominoperineal intersphincteric resection combined with ileostomy is safe and feasible for the treatment of ultra-low rectal cancer, and it leads to satisfactory anal function and a short-term curative effect.
