Clinical efficacy of laparoscopic modified Parks operation on the ultra-low rectal cancer / 中南大学学报(医学版)

OBJECTIVES@#To investigate the clinical efficacy of laparoscopic modified Parks operation on the patients with ultra-low rectal cancer.@*METHODS@#According to the preoperative stage and intraoperative anastomotic position, 98 patients with ultra-low rectal cancer above T2 stage underwent laparoscopic Dixon operation, modified Parks operation and Miles operation, respectively. All patients were divided into 3 groups: a Dixon operation group (@*RESULTS@#The patients were more obese, the distance between tumor and anal margin was closer, and the operation time was longer in the modified Parks operation group than those in the Dixon operation group (all @*CONCLUSIONS@#Laparoscopic modified Parks operation is a safe, economical and effective anus preservation operation, which can not only save the anus for some patients who had to perform Miles operation, but also recover better and faster after operation. Although the early anal function of patients performed with the modified operation is poor, it can gradually recover to the same level as the patients performed with the Dixon operation.

Current state and progress of preserving anal function in treatment of low or ultral-low rectal cancer / 中国内镜杂志

As the development of society, people pay more attention to life quality. Nowadays, the therapeutic strategy to low or ultra-low rectal cancer has turned to anussaving as important as radical resection. Following the deep research in biology rule-rs of rectal cancer and a series of important theories, such as the 2 cm distal resection margin, total mesorectal excision technique, pelvic autonomic nerve preservation, variet-y of surgical methods can be chose in dealing with low or ultra-low rectal cancer a-nd achieving the goal of anus preservation. But, because of so many organs around the low or ultra-low rectal cancer and complicated anatomy, we should select patients strictly in order to avoid preserve one's anus blindly. if not, patients will face the condition of residual neoplasms or severe incontinence.

Laparoscopy combined with total intersphincteric resection for extremely low rectal cancer / 中南大学学报(医学版)

To investigate the feasibility and therapeutic effect of laparoscopy combined with total intersphincteric resection (Total-ISR) for extremely low rectal cancer.
 Methods: We performed laparoscopy combined with Total-ISR in 45 patients with extremely low rectal cancer (1.0 cm≤the lower edge of tumor to the anal edge≤3.0 cm) from January 2014 to December 2016. The operation time, blood loss, resection margin and overall incidence of postoperative complications were observed. The rate of local recurrence and distant metastasis after surgery during the median following-up time of 20.5 months were observed. Anal function at 3, 6, and 12 months after operation were compared.
 Results: The operation for 45 cases were successful without perioperative death. The operation time was (220±33) min and blood loss was (110±31) mL. The surgical margins were all negative. The incidence of postoperative complication was 6.7% (3/45) and no one suffered anastomotic leakage. After a median follow-up of 20.5 (6-30) months, 2 cases developed local recurrence and 1 case developed distant metastasis. According to Kirwan grade, the grade II was 24.4% (11/45), grade III was 57.8% (26/45) in 3 months after operation, and the grade II increased to 51.1% (23/45), the grade III decreased to 35.5% (16/45) after 6 months. Seven out of 40 patients in 12 months after operation reached the grade I, and 25 patients reached the grade II. There were significant differences between 3 months and 6 months, 6 months and 12 months after operation (P<0.05) in the anal function situation.
 Conclusion: It is feasible, for appropriate patients, to perform laparoscopic combined with total-ISR, especially for the patients with extremely low rectal cancer that were in early stage without invasion to the extemal sphincter. The procedure has the advantages of radical sphincter-saving, minimal invasion and economy.