Clinical application of obstructive lower rectal carcinoma laparoscopic sphincter-preserving operation

doi:10.3877/cma.j.issn.1674-6899.2016.06.008

Abstract

Abstract:

Objective

To explore the feasibility of sphincter-preserving operation for low rectal carcinoma.

Methods

Retrospective analysis of low rectal carcinoma of obstruction of sphincter-preserving operation(Dixon) surgery in patients with clinical data of 45 cases from our hospital between Jan. 2012 and Dec. 2015.

Results

Intestinal fistula from obstructive low rectal carcinoma sphincter-preserving operation group , including 6 cases (6/45, 13.3%) with full drainage after intestinal fistula healing, 5 cases of local recurrence, 3 cases with metastasis. Without any death after operations. In the Sphincter-preserving operation group, there was an advantage in the amount of bleeding (120 ± 3) ml and postoperative hospital stay (9 ± 1) d.

Conclusions

The appropriate cases selected, surgery or colonic irrigation and preventive colostomy for obstructive rectal carcinoma decreases can be used laparoscopic sphincter-preserving operation, which is not only able to recover a good bowel movement and then control functions, but also can be achieved Miles and the same radical surgery, obtaining the similar effect.

Key words: Rectal carcinoma, Obstructive, Low, Sphincter-preserving operation, Fistula

Anshu Xu, Chaochun Fu, Shibo Zhang, Yongping Xu, Xin Shi, Guan Lu, Jie Li, Xiaobin Yang. Clinical application of obstructive lower rectal carcinoma laparoscopic sphincter-preserving operation[J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2016, 09(06): 348-350.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhqjwkzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-6899.2016.06.008

https://zhqjwkzz.cma-cmc.com.cn/EN/Y2016/V09/I06/348

Figures/Tables 2

References 17

1	茆家定，吴佩，杨光，等. 超低位直肠癌保肛术的临床应用价值[J]. 中华消化外科杂志，2015, 14 (6): 461-465.
2	徐安书，傅朝春，孙勇，等. 腹腔镜在直肠癌根治术中的应用体会[J]. 腹腔镜外科杂志，2013，18 (9): 669-671.
3	甘建新，车向明，李海军，等．直肠癌淋巴结转移规律及其影响因素[J]．中国普通外科杂志，2012，27(10): 1201-1204.
4	Bujko K, Rutkowski A, Chang GJ, et al.Is the 1 cm rule of distal bowel resection margin in rectal cancer based on clinical evidence？A systematic review[J]．Ann Surg Oncol, 2012, 19 (3): 801-808.
5	顾晋．中低位直肠癌行保肛手术值得关注的几个问题[J]．中国实用外科杂志，2014，34 (9): 797-798.
6	刘献棠，吴印爱，王志伟，等．低位三管引流预防低位直肠癌保肛术后吻合口瘘的效果[J/CD]．中华普外科手术学杂志：电子版，2008, 2 (2): 211-213.
7	Park JS, Choi GS, Kim SH, et al.Muhicenter analysis ofrisk factors for anastomotic leakage after laparoscopic rectal cancer excision: the Korean laparoseopic colorectal surgery study group[J]．Ann Surg, 2013, 257 (4): 665-671.
8	Bakker IS, Snijders HS, Wouters MW, et al, High complication rate after low anterior resection for mid and high rectal cancer；results of a population－based study[J]．Eur J Surg Oncol, 2014, 40 (6): 692-698.
9	Kang CY, Halabi WJ, Chaudhry OO, et al.Risk factors for anstomotic leakage after anterior resection for rectal cancer[J]．JAMA Surg, 2013, 148 (1): 65-71.
10	Yang L, Huang XE, Zhou JN.Risk assessment on anastomotic leakage after rectal cancer surgery: an analysis of 753 patients[J]．Asian Pac Cancer Prev, 2013, 14(7): 4447-4453.
11	Kawada K, Hasegawa S, Hida K, el al.Risk factors for anastomotic leakage after laparoscopic low anterior resection with DST anastomosis[J]．Surg Endosc, 2014, 28 (10): 2988-2995.
12	刘飞德，姚胜，陈锋，等. 改良全腹腔镜下直肠癌前切除经肛拖出吻合重建的临床应用[J/CD]. 中华腔镜外科杂志：电子版，2015, 8 (4): 18-20.
13	罗建管，梁鹏，肖波．低位直肠癌保肛手术临床观察(附48例报告)[J]．中国现代医学杂，2008, 16 (8): 2412-2415.
14	邱清泉，何明学．低位直肠癌保肛手术适应症探讨[J]．内蒙古中医药，2007, 12 (1): 1-6.
15	许辉，贾文龙，邹文俊．二联式经肛外手工吻合在腹腔镜超低位直肠癌保肛术中的应用[J]．中国医师进修杂志，2011, 34 (8): 12-14.
16	徐宗斌，林惠铭，池畔．腹腔镜与开腹中低位直肠癌保肛手术后并发症的比较[J]. 肿瘤学杂志，2016, 12 (1): 50-53.
17	徐艳松，赵波，唐卫中．老年患者腹腔镜结直肠癌根治术近期疗效分析[J/CD]. 中华腔镜外科杂志：电子版，2013，6(6): 425-429.

组别	例数	手术时间(min， ±s)	术中出血量(ml, ±s)	清扫淋巴结数目(枚， ±s)	术后住院时间(d, ±s)	并发症(例)
保肛组	45	152 ± 11	120 ± 3	12 ± 3	9 ± 1	6
对照组	50	145 ± 5	160 ± 8	13 ± 4	14 ± 1	8
P值	?	> 0.05	< 0.05	> 0.05	< 0.05	> 0.05

组别	例数	手术时间(min， ±s)	术中出血量(ml, ±s)	清扫淋巴结数目(枚， ±s)	术后住院时间(d, ±s)	并发症(例)
保肛组	45	152 ± 11	120 ± 3	12 ± 3	9 ± 1	6
对照组	50	145 ± 5	160 ± 8	13 ± 4	14 ± 1	8
P值	?	> 0.05	< 0.05	> 0.05	< 0.05	> 0.05

组别	例数	局部肿瘤复发		肿瘤转移
组别	例数	有	无	有	无
保肛组	45	5	40	3	42
对照组	50	6	44	7	43
P值	?	> 0.05		> 0.05

组别	例数	局部肿瘤复发		肿瘤转移
组别	例数	有	无	有	无
保肛组	45	5	40	3	42
对照组	50	6	44	7	43
P值	?	> 0.05		> 0.05

[1]	Heng Lyu, Haiqin Xie, Xiangmei Chen, Yue Wang, Li Liu, Desheng Sun. Influence of information management system of follow-up data on diagnostic efficiency of ultrasonic physicians [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(08): 812-815.
[2]	Bingsheng Cao, Gengchen Zhang, Juan Deng. Efficacy of ultrasound-guided percutaneous nephrostomy for patients with single tuberculous kidney with obstructive ureter [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2021, 18(07): 701-704.
[3]	Peipei Zhou, Yanan Wu, Ying Wang, Ran Wang. Risk factors of lower respiratory tract infection for children with tracheobronchial foreign body [J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2021, 15(04): 276-280.
[4]	Li Song, Yanjie Liu, Husheng Li, Shu Guo, Rongyu Yan, Yi Lu, Xia Sheng. Design and application of a waterproof surgical bag in urological surgery [J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(04): 309-312.
[5]	Pai Lin, Yanchao Lin, Zechang Huang. Effect of color Doppler ultrasonography combined with high and low frequency probe and bipartite scanning on the diagnostic accuracy of inguinal hernia [J]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2021, 15(04): 372-374.
[6]	Huaping Chen, Zhixin Gan, Gang Liu, Shuanglin Liu, Yu Liu, Yuding Jiao, Diannan Miao, Jing Xu, Guansong Wang, Zhi Xu, Qi Li, Mingdong Hu. Study of morbidity and mortality in chronic obstructive pulmonary disease with co-morbidity and complications [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(04): 417-421.
[7]	Lin Li, Lu Liu, Fang He. Curative effect of humidified high-flow nasal cannula oxygen therapy on AECOPD with type Ⅱ respiratory failure [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(04): 422-426.
[8]	Lu Liu, Qian Lai. Therapeutic effects of aerosol inhalation of budesonide on acute exacerbation of chronic obstructive pulmonary disease with type 2 diabetes mellitus and the influence on pulmonary ventilation function and glucose metabolism indicators [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(04): 427-430.
[9]	Hongqian Liu, Chengjun Wang, Ranran Yan, Tai Jiu, Xiying Feng. Correlation between obstructive sleep hypopnea syndrome and peripheral airway resistance in Qinghai Province [J]. Chinese Journal of Lung Diseases(Electronic Edition), 2021, 14(04): 431-435.
[10]	Qinglin Hu, Pingping Huang. Advances in mesenchymal stem cells in treatment of diabetic lower limb ischemia [J]. Chinese Journal of Cell and Stem Cell(Electronic Edition), 2021, 11(04): 246-250.
[11]	Jian Wan, Caixi Tang. Diagnosis and treatments for multiple internal biliary fistula at gallbladder, duodenum, colon: report of one case [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2021, 10(05): 530-532.
[12]	Sen Hou, Shidong Zhao, Fan Liu, Yingjiang Ye. Safety and efficiency of side-to-end anastomosis versus straight colorectal anastomosis in low anterior resections [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(04): 371-378.
[13]	Haoyue Zhang, Yang Zhang, Yehuang Wang. Clinical study on the management of wounds after high complex anal fistula operation by sucking-irrigation balance method of traditional Chinese medicine [J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2021, 10(04): 379-384.
[14]	Can Zhao, Peipei Sun, Erming Zhang, Xinhua An, Shitou Ma, Liyong Liu, Pingchao Xiang. Association of smoking and second-hand smoking with chronic obstructive pulmonary disease among residents aged 40 years or above in 10 communities of Beijing City [J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(06): 450-458.
[15]	Ning Yu, Chengbo Li, Min Li, Hairu Ji, Xiaoxuan Zhang. Clinical efficacy of Probucol combined with Atorvastatin for patients with acute ischemic stroke [J]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(04): 249-254.

Please choose a citation manager

Content to export