Effect of Pelvic Floor Reconstruction Following Laparoscopic Abdominoperineal Resec-tion on Postoperative Complications for Low Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LIUYong , XIAJun-qiang , ZHANGQin

Department of Gastrointestinal Surgery, Shihezi People's Hospital of Xinjiang, Shihezi 832000, Xinjiang, China;

Corresponding?author：

LIUYong, Email: liuyong831@sina.cn

Keywords：

Rectal cancer; Laparoscope; Abdominoperineal resection; Pelvic floor reconstruction

DOI：

10.7507/1007-9424.20160351

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore necessity, safety, and clinical significance of pelvic floor reconstruction following laparoscopic abdominoperineal resection for low rectal cancer. Methods Thirty-seven patients with low rectal cancer admitted to our hospital from July 2013 to January 2016 were collected, who were divided into reconstruction group and non-reconstruction group according to the pelvic floor reconstruction or not. The complications were compared in two groups. Results The laparoscopic abdominoperineal resections were successfully completed in all the patients with low rectal cancer, there was no case of conversion to open surgery. The operative time was (173.6±18.3) min, the suture time of pelvic floor peritoneal was (28.6±7.5) min. The postoperative following-up was 3-24 month. There were 5 cases (22.7%) of complications in the non-reconstruction group, included 2 cases of adhesive intestinal obstruction, 1 case of perineal incision hernia, 1 case of pelvic effusion and infection, 1 case of radiation enteritis caused by radiotherapy. There was 1 case (6.7%) of adhesive intestinal obstruction in the reconstruction group. Although the incidence of postoperative complications in the reconstruction group was lower than that in the non-reconstruction group, there was no significant difference between these two groups (χ²=2.367, P=0.096 1). Conclusion The preliminary results of limited cases in this study show that it is not essential for pelvic floor reconstruction following laparoscopic abdominoperineal resection for rectal cancer, but it could obviously decrease difficulty of operation for postoperative reoperation, especially for postoperative radiotherapy patients, and prevent occurrence of radiation enteritis. It is still necessary because it is more consistent with principle of open surgery, Hem-o-lok 3-0 Angiotech Quilltm clip or barbed suture closure of pelvic peritoneum, it is technically safe and feasible.

Citation： LIUYong, XIAJun-qiang, ZHANGQin. Effect of Pelvic Floor Reconstruction Following Laparoscopic Abdominoperineal Resec-tion on Postoperative Complications for Low Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(11): 1375-1378. doi: 10.7507/1007-9424.20160351 Copy

1.	王雁軍, 王青兵, 肖建安, 等. 腹膜外結腸造口在腹腔鏡直腸癌Miles術中的應用. 中華結直腸疾病電子雜志, 2016, 5(1):56-59.
2.	蔣松松, 陳剛, 吳鴻雁, 等. 中低位直腸癌環周切緣微轉移與臨床病理特征的相關性初探. 中華普通外科學文獻:電子版, 2016, 10(4):241-246.
3.	王亮, 張俊斌, 齊鑫, 等. 直腸外翻拖出式腹腔鏡直腸癌根治術5例臨床分析. 中國普外基礎與臨床雜志, 2016, 23(5):604-606.
4.	馮安明, 張克難, 龐典付. 腹腔鏡輔助下切除低位直腸癌25例報告. 腹部外科, 2008, 21(1):26-27.
5.	劉乃青, 孫淑香, 周忠晉, 等. 腹膜外造口和盆底腹膜重建預防腹腔鏡下Miles術后造口旁疝和盆底腹膜粘連梗阻. 中華普通外科雜志, 2014, 29(10):804-805.
6.	孔杰, 甘從存, 徐士杰, 等. 中低位直腸癌全直腸系膜切除術后吻合口瘺的危險因素分析. 中國普外基礎與臨床雜志, 2016, 23(2):210-213.
7.	李世擁, 陳剛, 杜俊峰, 等. 腹部無切口腹腔鏡直腸癌經肛門切除吻合術. 中華普外科手術學雜志:電子版, 2016, 10(2):91-93.
8.	胡明高, 李向國, 郭彪. 單吻合器法腹腔鏡全直腸系膜切除術與開腹手術的對照研究. 中華腔鏡外科雜志:電子版, 2016, 9(3):156-160.
9.	王梟杰, 池畔, 林慧銘, 等. 新輔助放化療對不同高度低位直腸癌保肛率的影響及其預后因素分析. 中華外科雜志, 2016, 54(6):419-423.
10.	Schmoll HJ, Van Cutsem E, Stein A, et al. ESMO Consensus Guide-lines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol, 2012, 23(10):2479-2516.
11.	中華人民共和國衛生和計劃生育委員會醫政醫管局, 中華醫學會腫瘤學分會. 結直腸癌診療規范(2015年版). 中華外科雜志, 2015, 53(12):881-894.
12.	Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol, 2015, 20(2):207-239.
13.	張永康, 劉韻. 腹腔鏡下直腸癌超低位保肛手術108例報告. 中國微創外科雜志, 2016, 16(4):294-296.
14.	任鏡清, 劉建偉, 劉少杰, 等. 腹腔鏡結直腸癌根治術與開腹手術近遠期療效的比較. 中華普通外科學文獻:電子版, 2012, 6(2):7-10.
15.	Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum:a proposal by the International Study Group of Rectal Cancer. Surgery, 2010, 147(3):339-351.
16.	陳曦, 顏登國, 梁正子, 等. 影響結直腸印戒細胞癌遠期生存的因素分析. 中國普外基礎與臨床雜志, 2016, 23(8):987-990.
17.	劉洪洲, 李永勝, 陳俊生, 等. 腹腔鏡Miles術重建盆底腹膜14例技巧體會. 中華普通外科學文獻:電子版, 2014, 8(2):135-136.
18.	Keller DS, Ibarra S, Flores-Gonzalez JR, et al. Outcomes for single-incision laparoscopic colectomy surgery in obese patients:a case-matched study. Surg Endosc, 2016, 30(2):739-744.
19.	賀曼, 索瑞鑫, 仇玉蘭. 結直腸癌手術患者預后影響因素的時協變量Cox回歸分析. 腫瘤研究與臨床, 2016, 28(5):318-321.
20.	林國樂, 邱輝忠, 肖毅, 等. TEM縫合技術關閉盆底腹膜在腹腔鏡直腸癌腹會陰聯合切除術中的應用. 中國現代手術學雜志, 2014, 16(5):321-325.
21.	袁捷, 徐小雯, 傅傳剛, 等. Hem-o-lok聚合物結扎夾在腹腔鏡輔助經腹會陰聯合直腸癌根治術盆底重建中的臨床應用. 中華胃腸外科雜志, 2015, 18(11):1168-1170.
22.	丁衛星, 盧列勝. 腹腔鏡直腸癌切除術后盆底腹膜縫合關閉技術. 腹腔鏡外科雜志, 2012, 17(5):336-338.
23.	錢正海, 黃維賢, 郎建華, 等. 腹腔鏡Miles術中盆底腹膜重建的應用. 現代醫藥衛生, 2014, 30(23):43-48.
24.	王舉, 王永強, 姜宏偉, 等. 腹腔鏡下腹膜外造口聯合盆底腹膜關閉方法臨床分析. 中華腔鏡外科雜志, 2015, 8(1):43-48.
25.	申連東, 齊文海. 術前營養風險與直腸癌前切術后吻合口瘺的相關性分析. 中國普外基礎與臨床雜志, 2016, 23(4):454-457.

1. 王雁軍, 王青兵, 肖建安, 等. 腹膜外結腸造口在腹腔鏡直腸癌Miles術中的應用. 中華結直腸疾病電子雜志, 2016, 5(1):56-59.
2. 蔣松松, 陳剛, 吳鴻雁, 等. 中低位直腸癌環周切緣微轉移與臨床病理特征的相關性初探. 中華普通外科學文獻:電子版, 2016, 10(4):241-246.
3. 王亮, 張俊斌, 齊鑫, 等. 直腸外翻拖出式腹腔鏡直腸癌根治術5例臨床分析. 中國普外基礎與臨床雜志, 2016, 23(5):604-606.
4. 馮安明, 張克難, 龐典付. 腹腔鏡輔助下切除低位直腸癌25例報告. 腹部外科, 2008, 21(1):26-27.
5. 劉乃青, 孫淑香, 周忠晉, 等. 腹膜外造口和盆底腹膜重建預防腹腔鏡下Miles術后造口旁疝和盆底腹膜粘連梗阻. 中華普通外科雜志, 2014, 29(10):804-805.
6. 孔杰, 甘從存, 徐士杰, 等. 中低位直腸癌全直腸系膜切除術后吻合口瘺的危險因素分析. 中國普外基礎與臨床雜志, 2016, 23(2):210-213.
7. 李世擁, 陳剛, 杜俊峰, 等. 腹部無切口腹腔鏡直腸癌經肛門切除吻合術. 中華普外科手術學雜志:電子版, 2016, 10(2):91-93.
8. 胡明高, 李向國, 郭彪. 單吻合器法腹腔鏡全直腸系膜切除術與開腹手術的對照研究. 中華腔鏡外科雜志:電子版, 2016, 9(3):156-160.
9. 王梟杰, 池畔, 林慧銘, 等. 新輔助放化療對不同高度低位直腸癌保肛率的影響及其預后因素分析. 中華外科雜志, 2016, 54(6):419-423.
10. Schmoll HJ, Van Cutsem E, Stein A, et al. ESMO Consensus Guide-lines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Ann Oncol, 2012, 23(10):2479-2516.
11. 中華人民共和國衛生和計劃生育委員會醫政醫管局, 中華醫學會腫瘤學分會. 結直腸癌診療規范(2015年版). 中華外科雜志, 2015, 53(12):881-894.
12. Watanabe T, Itabashi M, Shimada Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) Guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol, 2015, 20(2):207-239.
13. 張永康, 劉韻. 腹腔鏡下直腸癌超低位保肛手術108例報告. 中國微創外科雜志, 2016, 16(4):294-296.
14. 任鏡清, 劉建偉, 劉少杰, 等. 腹腔鏡結直腸癌根治術與開腹手術近遠期療效的比較. 中華普通外科學文獻:電子版, 2012, 6(2):7-10.
15. Rahbari NN, Weitz J, Hohenberger W, et al. Definition and grading of anastomotic leakage following anterior resection of the rectum:a proposal by the International Study Group of Rectal Cancer. Surgery, 2010, 147(3):339-351.
16. 陳曦, 顏登國, 梁正子, 等. 影響結直腸印戒細胞癌遠期生存的因素分析. 中國普外基礎與臨床雜志, 2016, 23(8):987-990.
17. 劉洪洲, 李永勝, 陳俊生, 等. 腹腔鏡Miles術重建盆底腹膜14例技巧體會. 中華普通外科學文獻:電子版, 2014, 8(2):135-136.
18. Keller DS, Ibarra S, Flores-Gonzalez JR, et al. Outcomes for single-incision laparoscopic colectomy surgery in obese patients:a case-matched study. Surg Endosc, 2016, 30(2):739-744.
19. 賀曼, 索瑞鑫, 仇玉蘭. 結直腸癌手術患者預后影響因素的時協變量Cox回歸分析. 腫瘤研究與臨床, 2016, 28(5):318-321.
20. 林國樂, 邱輝忠, 肖毅, 等. TEM縫合技術關閉盆底腹膜在腹腔鏡直腸癌腹會陰聯合切除術中的應用. 中國現代手術學雜志, 2014, 16(5):321-325.
21. 袁捷, 徐小雯, 傅傳剛, 等. Hem-o-lok聚合物結扎夾在腹腔鏡輔助經腹會陰聯合直腸癌根治術盆底重建中的臨床應用. 中華胃腸外科雜志, 2015, 18(11):1168-1170.
22. 丁衛星, 盧列勝. 腹腔鏡直腸癌切除術后盆底腹膜縫合關閉技術. 腹腔鏡外科雜志, 2012, 17(5):336-338.
23. 錢正海, 黃維賢, 郎建華, 等. 腹腔鏡Miles術中盆底腹膜重建的應用. 現代醫藥衛生, 2014, 30(23):43-48.
24. 王舉, 王永強, 姜宏偉, 等. 腹腔鏡下腹膜外造口聯合盆底腹膜關閉方法臨床分析. 中華腔鏡外科雜志, 2015, 8(1):43-48.
25. 申連東, 齊文海. 術前營養風險與直腸癌前切術后吻合口瘺的相關性分析. 中國普外基礎與臨床雜志, 2016, 23(4):454-457.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Pelvic Floor Reconstruction Following Laparoscopic Abdominoperineal Resec-tion on Postoperative Complications for Low Rectal Cancer

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