Clinical application of artificial anal reconstruction after laparoscopic abdominoperineal resection in low rectal cancer patients / 中华胃肠外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To assess the outcome and quality of life artificial anal reconstruction after laparoscopic abdominoperineal resection(APR) in low rectal cancer patients.</p><p><b>METHODS</b>Clinical data of 60 cases with low rectal cancer undergoing APR in our department from January 2010 to January 2013 were retrospectively analyzed. Sixty patients were divided into 2 groups according to anal reconstruction procedure, inclding 32 patients of abdominal colostomy as colostomy group and 28 patients of in-situ artificial anal reconstruction as anal reconstruction group. After a median follow-up of 1 year, the quality of life was assessed by Fetal Incontinence Quality of Life Scale(FIQL scale) and Cleveland Clinic Florida Fecal Incontinence Scores(CCS-FIS scale). In addition, the outcome and complications were compared between the two groups.</p><p><b>RESULTS</b>Compared with the colostomy group, the anal reconstruction group presented longer operation time [(204.8 ± 18.8) min vs. (173.3 ± 23.5) min, P<0.01], later passage time [(45.1 ± 9.3) h vs. (27.7 ± 9.4) h, P<0.01], and higher incidence of mucosal edema(42.9% vs. 18.8%, P<0.05). There were no significant differences in average hospital stay and other complication morbidities(all P>0.05). After follow-up, the embarrassment scale in anal reconstruction group was better compared to colostomy group(3.1 vs. 2.2, P<0.01). However, there were no significant differences in the lifestyle, coping and depression scales between the two groups (all P>0.05). Twenty(71.4%) patients in anal reconstruction group had satisfactory continence 1 year after operation.</p><p><b>CONCLUSION</b>In-situ artificial anal reconstruction after laparoscopic abdominoperineal resection can preserve fecal function in low rectal cancer patients and improve the quality of life after APR operation.</p>