Lone-Star retractor perineal exposure method for laparoscopic abdominal perineal resection of rectal cancer

作     者：Jun Ma Dai-Bin Tang Yu-Quan Tang Da-Tian Wang Peng Jiang Ya-Ming Zhang 

作者机构：Department of General SurgeryAnqing Municipal HospitalAnqing 246000Anhui ProvinceChina Department of AnesthesiologyAnqing Municipal HospitalAnqing 246000Anhui ProvinceChina 

出 版 物：《World Journal of Gastrointestinal Surgery》 (世界胃肠外科杂志（英文版）（电子版）)

年 卷 期：2024年第16卷第8期

页      面：2528-2537页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：the Research Projects Foundation at Universities of Anhui Province,No.2023AH050577 Research Projects Foundation at the Science and Technology Bureau of Anqing City,No.2023Z1001 

主　　题：Rectal cancer Lone-Star retractor Abdominal perineal resection Perineal exposure method Technique 

摘      要：BACKGROUND The abdominal perineal resection(APR),historically referred to as Mile’s proce-dure,stands as a time-honored surgical intervention for rectal cancer *** in surgical techniques and the advent of neoadjuvant therapies have significantly improved the rate of sphincter preservation among patients afflicted with rectal cancer,including those with ultralow rectal *** these improvements,APR maintains its irreplaceable role in the clinical landscape,particularly for cases involving low rectal cancer with encroachment on the external anal sphincter or levator ani *** perineal exposure stands as a pivotal phase in APR,given that the precision of this maneuver is directly correlated with both the safety of the surgery and the patient’s subse-quent long-term *** To evaluate the value of Lone-Star retractor(LSR)perineal exposure method in the treatment for laparoscopic APR of rectal *** We reviewed the records of 38 patients with rectal cancer at Anqing Municipal Hospital from January 2020 to December 2023,including 20 patients who underwent the APR procedure with a LSR perineal exposure method(LSR group)and 18 patients who underwent the APR procedure with a conventional perineal exposure method(control group).In the LSR group,following incision of the skin and subcutaneous tissue,the LSR was placed and dynamically adjusted according to the surgical plane to fully expose the perineal operative *** A total of 38 patients underwent laparoscopic APR,none of whom were found to have distant metastasis upon intraoperative *** blood loss,the postoperative hospital stays and the wound pain scores in the LSR group were significantly lower than those in the control group.A single surgeon completed the perineal operation significantly more often in the LSR group than in the control group(P0.05).The incidence of infection via the perineal incision in the LSR group was significantly lower