Application of Laparoscopic Extralevator Abdominoperineal Excision in Locally Advanced Low Rectal Cancer

作     者：Yan-Lei Wang Yong Dai Jin-Bo Jiang Hui-Yang Yuan San-Yuan Hu Wang Yan-Lei;Dai Yong;Jiang Jin-Bo;Yuan Hui-Yang;Hu San-Yuan

作者机构：Department of General SurgeryQilu Hospital of Shandong UniversityJinanShandong 250012China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2015年第128卷第10期

页      面：1340-1345页

核心收录：

学科分类：090603[农学-临床兽医学] 12[管理学] 1201[管理学-管理科学与工程(可授管理学、工学学位)] 08[工学] 09[农学] 0906[农学-兽医学] 

主　　题：Abdominoperineal Resection Circumferential Margin Extralevator Abdominoperineal Excision Laparoscopy Low Rectal Cancer 

摘      要：Background：When compared with conventional abdominoperineal resection （APR）,extralevator abdominoperineal excision （ELAPE） has been demonstrated to reduce the risk of local recurrence for the treatment of locally advanced low rectal *** with the laparoscopic technique,laparoscopic ELAPE （LELAPE） has the potential to reduce invasion and hasten postoperative *** this study,we aim to investigate the advantages of LELAPE in comparison with conventional ***：From October 2010 to February 2013,23 patients with low rectal cancer （T3-4N0-2M0） underwent LELAPE;while during the same period,25 patients were treated with conventional *** patient characteristics,intraoperative data,postoperative complications,and follow-up results were retrospectively compared and ***：The basic patient characteristics were similar;but the total operative time for the LELAPE was longer than that of the conventional APR group （P =0.014）.However,the operative time for the perineal portion was comparable between the two groups （P =0.328）.The LELAPE group had less intraoperative blood loss （P =0.022）,a lower bowel perforation rate （P =0.023）,and a positive circumferential margin （P =0.028）.Moreover,the patients,who received the LELAPE,had a lower postoperative Visual Analog Scale,quicker recovery of bowel function （P =0.001）,and a shorter hospital stay （P =0.047）.However,patients in the LELAPE group suffered more chronic perineal pain （P =0.002）,which may be related to the coccygectomy （P =0.033）.Although the metastasis rate and mortality rate were similar between the two groups,the local recurrence rate of the LELAPE group was statistically improved （P =0.047）.Conclusions：When compared with conventional APR,LELAPE has the potential to reduce the risk of local recurrence,and decreases operative invasion for the treatment of locally advanced low rectal cancer.