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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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.	B?rlehner 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, 汪曉東, 等.高齡直腸或肛管癌患者的兩種極限保肛術式的術后近期結果的比較研究[J].中國普外基礎與臨床雜志, 2013, 22(11):1250-1256.
13.	梁小波, 侯生槐, 李國棟, 等.腹腔鏡直腸癌手術的療效分析[J].中華消化外科雜志, 2010, 9(6):411-414.
14.	張翔, 陳旭, 蔣雪松, 等.腹腔鏡手術治療結直腸癌[J].中華消化外科雜志, 2009, 8(5):385-386.

1. ?衛生部醫政司, 結直腸癌診療規范專家工作組.結直腸癌診療規范(2010年版)[J].中華胃腸外科雜志, 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, 張永軍, 張東銘.肛管直腸角的作用及臨床應用[J].中國臨床解剖學雜志, 1989, 7(2):96-98, 127.
4. 魏東, 葛雪燕, 高春芳.直腸癌根治會陰部人工肛門重建術2600例[J].實用醫藥雜志, 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, 林惠銘, 盧星榕, 等.確保腹腔鏡直腸系膜完全切除的手術技巧:介紹一種自創骶前隧道式分離法[J].中華胃腸外科雜志, 2009, 12(3):317-318.
7. 池畔.腹腔鏡直腸癌全直腸系膜切除手術技巧[J].中華胃腸外科雜志, 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. B?rlehner 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, 汪曉東, 等.高齡直腸或肛管癌患者的兩種極限保肛術式的術后近期結果的比較研究[J].中國普外基礎與臨床雜志, 2013, 22(11):1250-1256.
13. 梁小波, 侯生槐, 李國棟, 等.腹腔鏡直腸癌手術的療效分析[J].中華消化外科雜志, 2010, 9(6):411-414.
14. 張翔, 陳旭, 蔣雪松, 等.腹腔鏡手術治療結直腸癌[J].中華消化外科雜志, 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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