Minilaparotomy approach for curative resection of colorectal cancer / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the feasibility and safety of a minilaparotomy approach for curative resection of colorectal cancer in comparison with the conventional laparotomy.</p><p><b>METHODS</b>Seventy-eight patients underwent radical resection for rectal cancer with minilaparotomy during April 2001 to December 2002. The minilaparotomy involved complete resection and a skin incision 2 cm above the link line of left anterior superior iliac spine to pubic symphysis and was about 7-10 cm in length. Another 86 patients who served as control group underwent a similar resection with a conventional laparotomy during the same period.</p><p><b>RESULT</b>The minilaparotomy approach was successful in all 78 patients. The general status of patients, operative types and histopathological features of tumor were similar in the two groups (P>0.05). Operative blood loss in control group was greater (P<0.001), whereas incision length in minilaparotomy group was significantly shorter than that in conventional laparotomy (9.38 cm compared with 17.32 cm). The operative time, analgesia requirement, first passing flatus,first oral fluids and postoperative hospital stay were significantly shorter in the minilaparotomy group (P<0. 001). In an average 25.4-month follow-up, there were no tumor recurrences in the minilaparotomy group.</p><p><b>CONCLUSION</b>A minilaparotomy approach for curative resection of rectal cancer may be an ideal alternative approach to conventional laparotomy.</p>

The prognosis of the total proctocolectomy and ileal-pouch anal anastomosis / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the prognosis of the total proctocolectomy and ileal-pouch anal anastomosis (IPAA) for ulcerative colitis (UC) and familial adenomatous polyposis (FAP).</p><p><b>METHODS</b>Sixty-one patients with ulcer colitis or familial adenomatous polyposis were performed total proctocolectomy and ileal pouches-anal anastomosis during 1985 to 2002. There are S type pouch 25 cases, S-J type pouch 13 cases, J type pouch 17 cases and W type pouch 6 cases. The complication and function after the IPAA were also discussed.</p><p><b>RESULTS</b>No patient died after operation. The total morbidity is 16% (10/61), the morbidity of group UC (6/25) is higher than FAP's (4/34). The W type pouch's morbidity is higher than other three types', the operation with stapled technique is associated with fewer complication than hand-sewn IPAA (2/20 vs 8/41), however, there is also no significant difference between them. The number of stools per 24 hours is 4.2, the percent of the normal continence of daytime and nighttime is 84% (43/51) and 75% (38/51) respectively. There's only about 6% (3/51) patient with fecal incontinence. The most patients are satisfied with IPAA.</p><p><b>CONCLUSION</b>The proctocolectomy ileal pouch-anal anastomosis for FAP and UC has few complication with accepted frequency and preserve a good anal function, it is an ideal alternative approach.</p>