ABSTRACT
Objective:To investigate the effect of the distance of the circumferential resection margin (CRM) on postoperative recurrence after laparoscopic radical resection of colon cancer.Methods:The clinical data of 83 patients who underwent laparoscopic radical resection of colon cancer in Yiwu Central Hospital from January 2020 to January 2022 were retrospectively included. They were divided into recurrent group (16 cases) and non-recurrent group (67 cases) according to the recurrence within 1 year after operation. The clinical data, postoperative CRM distance and laboratory indicators of the two groups were collected to analyze the influence of CRM distance on postoperative recurrence after laparoscopic radical resection of colon cancer.Results:The proportion of patients treated with postoperative chemotherapy, and postoperative CRM distance in the recurrent group were lower than those in the non-recurrent group: 9/16 vs. 83.58 % (56/67), (0.85 ± 0.23) mm vs. (1.64 ± 0.76) mm. The levels of CEA and CA19-9 at admission were higher than those in the non-recurrent group: (156.74 ± 11.58) μg/L vs. (149.96 ± 10.26) μg/L, (15.63 ± 2.77) kU/L vs. (14.04 ± 2.35) kU/L, and the differences were statistically significant ( P<0.05). Point binary correlation analysis showed that there was a negative correlation between CRM distance and postoperative recurrence after laparoscopic radical resection of colon cancer ( r = - 0.412, P<0.01). Multivariate Logistic regression analysis showed that the long distance of CRM was the protective factor of recurrence after laparoscopic radical resection of colon cancer ( OR<1, P<0.05). The results of the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of the CRM distance to predict the recurrence after laparoscopic radical resection of colon cancer was 0.833>0.7, and the predictive value was good. When the optimal threshold was 1.080 mm, the ideal sensitivity and specificity could be obtained 87.50% and 81.00%. Conclusions:The shorter the CRM distance after laparoscopic radical resection of colon cancer, the higher the risk of recurrence. The CRM distance can be used as a predictor of recurrence after laparoscopic radical resection of colon cancer.
ABSTRACT
To evaluate the clinical observation of rectal prolapse by partial perineal rectal sigmoidectomy.Methods Sixty patients with rectal prolapse who met the diagnostic criteria of rectal prolapse in Yiwu Central Hospital from April 2013 to June 2015 were selected as the research subjects.They were divided into two groups according to random number table ,with 30 cases in each group.The observation group used Altemeier ,and the control group underwent triple surgery ( rectal mucosal ligation ,periorbital injection,and anal ring retraction ).The total effective rate after surgery was compared and analyzed.Results The operation of the two groups was successfully completed.The total effective rate of the observation group was 96.67%,which was significantly higher than 80.00%of the control group,the difference was statistically significant ( χ2 ＝5.856,P ＝0.048).The Wexner constipation score of the observation group was (1.4 ±1.6) points,which was significantly lower than that of the control group [(3.2 ±2.0) points, t ＝3.849, P ＜0.05].The Wexner anal incontinence score of the observation group after 24 months was (2.9 ±1.8)points,which was significantly lower than that of the control group [(4.4 ±2.7) points, t＝2.532,P＜0.05].The proportions of anastomotic bleeding ,pelvic swelling and perianal eczema in the observation group were 0.00%,0.00%and 3.33%,respectively,which were significantly lower than those in the control group (20.00%,23.33%and 30.00%,χ2 ＝4.630,5.822,7.680,all P＜0.05).Conclusion Altemeier can significantly improve the quality of life of patients ,with a high cure rate and good clinical results.
ABSTRACT
Objective@#To evaluate the clinical observation of rectal prolapse by partial perineal rectal sigmoidectomy.@*Methods@#Sixty patients with rectal prolapse who met the diagnostic criteria of rectal prolapse in Yiwu Central Hospital from April 2013 to June 2015 were selected as the research subjects.They were divided into two groups according to random number table, with 30 cases in each group.The observation group used Altemeier, and the control group underwent triple surgery (rectal mucosal ligation, periorbital injection, and anal ring retraction). The total effective rate after surgery was compared and analyzed.@*Results@#The operation of the two groups was successfully completed.The total effective rate of the observation group was 96.67%, which was significantly higher than 80.00% of the control group, the difference was statistically significant(χ2=5.856, P=0.048). The Wexner constipation score of the observation group was (1.4±1.6)points, which was significantly lower than that of the control group[(3.2±2.0)points, t=3.849, P<0.05]. The Wexner anal incontinence score of the observation group after 24 months was (2.9±1.8)points, which was significantly lower than that of the control group [(4.4±2.7)points, t=2.532, P<0.05]. The proportions of anastomotic bleeding, pelvic swelling and perianal eczema in the observation group were 0.00%, 0.00% and 3.33%, respectively, which were significantly lower than those in the control group(20.00%, 23.33% and 30.00%, χ2=4.630, 5.822, 7.680, all P<0.05).@*Conclusion@#Altemeier can significantly improve the quality of life of patients, with a high cure rate and good clinical results.