Zhou Xiaocong, Su Meng, Hu Keqiong, Su Yinfa, Ye Yinghai, Huang Chongquan, Yu Zhenlei, Li Xiaoyang, Zhou Hong, Ni Yaozhong, Jiang Yi
Deparment of Surgery, The Dingli Clinical Institute of Wenzhou Medical University (Wenzhou Central Hospital) Wenzhou, Zhejiang, P.R. China.
Department of Radio-Chemotherapy Oncology, The First Affiliated Hospital of Wenzhou Medical University Wenzhou, Zhejiang, P.R. China.
Int J Clin Exp Med. 2015 Feb 15;8(2):2174-81. eCollection 2015.
This study aims to evaluate the predictive value of pelvic anatomical and clinical-pathological parameters that influence the success of sphincter preservation procedure (SPP).
We studied 42 consecutive patients who underwent low anterior resection (LAR) with double stapling technique (DST) anastomosis or abdominoperineal resection (APR) for mid-low rectal cancer between June 2009 and April 2014. The surgical procedures were performed by the same surgeon and surgical team at the Department of Surgery of Wenzhou Central Hospital. Pelvic dimensions and angles were measured using three-dimensional reconstruction of spiral computed tomography (CT) images. A number of clinical-pathological parameters were also examined. Univariate and multivariate analyses were performed to determine the predictive significance of these variables that might affect a successful SPP for mid-low rectal cancer.
Body mass index (BMI), distance of tumor from anal verge, and diameter of upper pubis to coccyx affected the success of SPP. It was the higher distance of tumor from anal verge, the higher BMI, and the larger diameter of upper pubis to coccyx contributed most to the success of SPP.
Diameter of upper pubis to coccyx is the only one of the pelvic anatomical parameters that could affect the success of SPP for mid-low rectal cancer patients. Furthermore, within the normal BMI range, higher BMI seemed to be a favorable factor for the success of SPP.
本研究旨在评估影响保肛手术（SPP）成功的盆腔解剖学和临床病理参数的预测价值。
我们研究了2009年6月至2014年4月期间连续接受低位前切除术（LAR）并采用双吻合器技术（DST）吻合或腹会阴联合切除术（APR）治疗中低位直肠癌的42例患者。手术由温州中心医院外科的同一位外科医生和手术团队进行。使用螺旋计算机断层扫描（CT）图像的三维重建测量盆腔尺寸和角度。还检查了一些临床病理参数。进行单因素和多因素分析以确定这些可能影响中低位直肠癌SPP成功的变量的预测意义。
体重指数（BMI）、肿瘤距肛缘距离以及耻骨上缘至尾骨直径影响SPP的成功。肿瘤距肛缘距离越高、BMI越高以及耻骨上缘至尾骨直径越大对SPP的成功贡献最大。
耻骨上缘至尾骨直径是唯一能影响中低位直肠癌患者SPP成功的盆腔解剖学参数。此外，在正常BMI范围内，较高的BMI似乎是SPP成功的有利因素。
