[Efficacy evaluation of intersphincteric resection during anus-preserving operation for ultralow rectal carcinoma].

OBJECTIVE: To evaluate anorectal dynamics, function and efficacy of ultralow rectal carcinoma patients undergone intersphincteric resection(ISR). METHODS: From January 2004 to August 2007, 30 patients with ultralow rectal carcinoma(2.5-4.0 cm distance from anal edge) underwent ISR. All the patients received anorectal manometry before and after operation. The postoperative anal function was evaluated by Williams continence standard and the treatment outcome was followed up. RESULTS: After ISR operation, anal resting pressure, maximum squeeze pressure and maximum tolerance volume of the rectum decreased significantly (all P<0.01) and restored gradually, but not to normal. The rectal anal inhibitory reflex disappeared in 27 patients(90.0%) and was not improved. According to Williams continence standard, 86.7%, 93.3% and 96.7% of patients obtained acceptable anal function in 3, 6, and 12 months after operation respectively. During follow-up of 12 to 44 months, all the patients were still alive and no patient developed pelvis or local recurrence, distant metastasis and anastomotic leakage. Fecal eczema of anus occurred in 10 patients, colonic mucosa prolapse in 2 patients and stenosis of anal canal in one patient. CONCLUSION: ISR for ultralow rectal carcinoma can not only attain radical treatment outcome, but also preserve anal sphincter.

[Combined preoperative xeloda and radiotherapy for lower rectal cancer].

OBJECTIVE: To evaluate the effect of combined preoperative xeloda and pelvic radiotherapy on locally advanced lower rectal cancer. METHODS: Sixty lower rectal cancer patients were divided randomly into two groups. 30 patients (Group A) were treated with operation alone and 30 patients (Group B) were treated with xeloda and radiotherapy before operation. RESULTS: The operative resection, anal preservation and local recurrence rates were 86.66%, 33.33%, 15.38% in group A and 100%, 83.33%, 0% in group B (P < 0.05 and P < 0.01). CONCLUSION: Combined preoperative xeloda and radiotherapy for lower rectal cancer is able to significantly improve the operative resection, anal preservation and decrease the local recurrence rates.