Application of indigenous staplers for anus-preservation and postoperative target chemotherapy in low-situated rectal cancer / 解放军医学杂志

ABSTRACT

Objective To evaluate the effects of indigenous staplers on anus-preservation,and postoperative target chemotherapy to prevent local recurrence and distant metastasis of low-situated rectal cancer.Methods 284 patients with low-situated rectal cancer hospitalized during Jan.1990 to Dec.2004 in the Second Affiliated Hospital of PLA General Hospital were treated surgically with indigenous staplers for anus-preservation,interoperative implantation of iliac artery pump and postoperative target infusion chemotherapy.They were followed up for 2~8 years.The clinical data including the result of anus-preservation,local recurrence rate,distant metastasis rate and long-term survival rate were retrospectively analyzed.Results All the 284 patients received anus-preservation operation with successful result.Among them 282 cases(99.3%) undervent the operation once,and the remaining two(0.7%) were operated on twice with success.Control of defecation was good in 247 cases(87.0%),anastomotic fistula occurred in 2 cases(0.7%),stanosis of anastomosis occurred in 1 case(0.4%),and bleeding from anastomotic site occurred in 1 case(0.4%).The follow-up data were completely collected from 236 cases(83.1%).The 1-,3-,5-year local recurrence was found in 2 cases(0.8%),6 cases(2.5%) and 8 cases(3.2%),respectively.The 1-,3-,5-year distant metastasis was found in 11 cases(4.7%),22 cases(9.3%) and 10 cases(4.3%),respectively.The 1-,3-,5-year overall survival rate were 97.0%(229/236),86.0%(203/236) and 65.3%(154/236),respectively.Conclusion The use of indigenous staplers is safe and dependable in operation for anus-preservation in low-situated rectal cancer.Postoperative target chemotherapy may decrease the local recurrence rate and distant metastasis rate,and raise the long-term survival rate as well.