ABSTRACT
Total mesorectal excision (TME) has become the basic principle of surgical treat-ment for middle and low rectal cancer. Some of patients with ultra-low rectal cancer require under-going intersphincteric resection (ISR). Due to the limitation of the narrow pelvis, TME and ISR put forward higher requirements for the precise separation of the anatomical level and the protection of neurological function during the operation. At present, evaluation of the difficulty of surgery for middle and low rectal cancer is mainly based on the subjective judgment of chief surgeon, and there is no unified and objective scoring system or prediction model that can classify the difficulty of surgery for middle and low rectal cancer before surgery. The authors review relevant literatures and summarize the existing studies related to pelvic measurement for predicting the difficulty of surgery for middle and low rectal cancer, in order to provide significant guidance for the selection of surgical approach for patients with middle and low rectal cancer.
ABSTRACT
Objective@#To investigate the sexual function, urinary function and quality of life in patients of ulcerative colitis(UC) and familial adenomatous polyposis(FAP) after total proctocolectomy and ileal pouch anal anastomosis (IPAA).@*Methods@#The clinical data of patients with UC and FAP undergoing IPAA at Zhongnan Hospital of Wuhan University from Jan 2006 to Sep 2018 were reviewed , postoperative sexual function, urinary function, and long-term quality of life were assessed.@*Results@#There were 45 patients with median age of 35 years , median follow-up time of 31 months. 18 were UC, 27 were FAP, 5 did 1-stage surgery, 37 did 2-stage surgery, 3 for 3-stage surgery, 13 underwent open surgery, and 32 underwent laparoscopic surgery. 7 patients suffered sexual dysfunction after IPAA, and there was no statistical difference between male and female (P=0.992), UC and FAP (P=0.153), 1-stage , 2-stage , and 3-stage surgery (P=0.363) , with statistically significant difference between the open group and the laparoscopic group (P=0.025). 6 patients complicated with urinary dysfunction after IPAA , and there was no statistical difference between male and female (P=0.562), UC and FAP (P=0.325), 1-stage, 2-stage, and 3-stage surgery (P=0.286) , with statistically significant difference between the open group and the laparoscopic group (P=0.007). The Cleveland Global Quality of Life (CGQL) score after IPAA was 0.696±0.085. There were no statistical difference on CGQL scores in males and females (P=0.635), UC and FAP (P=0.664), 1-stage, 2-stage, and 3-stage (P>0.05), open group and laparoscopic group (P=0.205), postoperative long-term QOL was significantly associated only with age at the time of surgery (P=0.001).@*Conclusions@#Compared with open surgery, laparoscopic TPC-IPAA patients had better postoperative sexual function and urination function.
ABSTRACT
Objective To investigate the sexual function,urinary function and quality of life in patients of ulcerative cohtis(UC) and familial adenomatous polyposis(FAP) after total proctocolectomy and ileal pouch anal anastomosis (IPAA).Methods The clinical data of patients with UC and FAP undergoing IPAA at Zhongnan Hospital of Wuhan University from Jan 2006 to Sep 2018 were reviewed,postoperative sexual function,urinary function,and long-term quality of life were assessed.Results There were 45 patients with median age of 35 years,median follow-up time of 31 months.18 were UC,27 were FAP,5 did 1-stage surgery,37 did 2-stage surgery,3 for 3-stage surgery,13 underwent open surgery,and 32 underwent laparoscopic surgery.7 patients suffered sexual dysfunction after IPAA,and there was no statistical difference between male and female (P =0.992),UC and FAP (P =0.153),1-stage,2-stage,and 3-stage surgery (P =0.363),with statistically significant difference between the open group and the laparoscopic group (P =0.025).6 patients complicated with urinary dysfunction after IPAA,and there was no statistical difference between male and female (P =0.562),UC and FAP (P =0.325),1-stage,2-stage,and 3-stage surgery (P =0.286),with statistically significant difference between the open group and the laparoscopic group (P =0.007).The Cleveland Global Quality of Life (CGQL) score after IPAA was 0.696 ± 0.085.There were no statistical difference on CGQL scores in males and females (P =0.635),UC and FAP (P =0.664),1-stage,2-stage,and 3-stage (P ＞ 0.05),open group and laparoscopic group (P =0.205),postoperative long-term QOL was significantly associated only with age at the time of surgery (P =0.001).Conclusions Compared with open surgery,laparoscopic TPC-IPAA patiems had better postoperative sexual function and urination function.