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