Clinical efficacy of laparoscopic modified Parks operation on the ultra-low rectal cancer. / è ¹è ”é•œä¸‹æ”¹è‰¯Parksæœ¯æ²»ç–—è¶ ä½Žä½ç›´è‚ ç™Œçš„ä¸´åºŠç–—æ•ˆ.

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 (n=39), a modified Parks operation group (n=43) and a Miles operation group (n=16). The clinical data and postoperative follow-up results were collected, compared, and analyzed to evaluate the clinical efficacy of laparoscopic modified Parks operation. 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 P<0.05). However, the results of bleeding volume, the number of lymph nodes and the postoperative complications in the modified park operation group were similar than those in the Dixon operation group (all P>0.05). In addition, the exhaust and defecation time and the hospitalization time were shorter, and the total cost of hospitalization was lower in the modified Parks operation group than those in the Dixon operation group (all P<0.05). Although the anal function in the modified Parks operation group was poor in the early postoperative period, it reached the same level as that in the Dixon operation group from 6 months after the treatments with the regular anal function exercise (P>0.05). There were no significant differences in tumor size, body shape, distance between tumor and anal margin, operation time, bleeding volume, number of lymph nodes detected, postoperative exhaust and defecation time between the Miles operation group and the modified Parks operation group, but the hospitalization time was shorter, the incidence of complications and the total cost of hospitalization were lower in the modified Parks operation group (all P<0.05). 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.

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.

Double stapling technique in anus-saving operation for lower rectal cancer / 中国普通外科杂志

Objective To determine the role of double stapling technique(DST) in anus-saving operations for lower rectal cancer. Methods The clinical data of 96 patients with lower rectal carcinoma treated by DST were analyzed retrospectively. Results There were 63 males and 33 females,aged from 22 to 84 (an average of 57.7 yesars). The distance from the lower end to dens line was 4～7cm.Dukes classfication: 24 patients belonged to A class, 30 B class, 30 C class,and 12 D class. Histological type: 47patients had high differentiation adenocarcinoma, 27 median differentiation adenocarcinoma, 17 low differentiation adenocarcinoma,and 5 mucous adenocarcinoma. No one died after the operation but 12 had anastomotic leakage(12.5%)postoperatively and all healed after treatment; 5 patients had anastomotic constriction(5.2%)postoperatively and all healed with expanding anus. Conclusions DST is a safe alternation for anus-saving operation for patients with rectal cancer.Conservative therapy is effective in the treatment of anastomotic constriction and anastomotic leakage.