Hepatobiliary and Enteric Surgery Research Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, China.
School of Pharmaceutical Science, Central South University, 172 Tongzip Road, Changsha, 410013, Hunan, China.
World J Surg Oncol. 2020 Feb 3;18(1):28. doi: 10.1186/s12957-020-1801-7.
To assess postoperative anal function and quality of life of ultra-low rectal cancer patients treated by laparoscopic modified Parks surgery.
From February 2017 to March 2019, 114 patients with ultra-low rectal cancer above T2 were treated respectively with ultra-low anterior resection (Dixon), modified coloanal anastomosis (modified Parks), and Miles according to the preoperative stage and anastomotic position. The postoperative anal function and Fecal Incontinence Quality of Life Scale (FIQL) of each patient were collected and synthetically analyzed.
Compared with the Dixon group, the postoperative anal function and FIQL in the Parks group were poor at the early stage. However, from 6 to 12 months after surgery, the scores of anal function and FIQL in the Parks group were similar to those in the Dixon group (P > 0.05). Compared with the Miles group, the FIQL of the two groups were similar in the early postoperative stage. However, with the passage of time, from 3 to 9 months after surgery, the four domains of FIQL in the Parks group were higher than those in the Miles group successively (P < 0.05).
Laparoscopic modified Parks is a safe, effective, and economical anus-preserving surgery. Although its early anal function and FIQL were poor, it could gradually recover to the similar level as Dixon. Moreover, it can save the anus and obtain a better postoperative quality of life for some patients who previously could only undergo Miles.
评估腹腔镜改良 Parks 手术治疗超低位直肠癌患者的术后肛门功能和生活质量。
2017 年 2 月至 2019 年 3 月，根据术前分期和吻合位置，分别对 T2 以上超低位直肠癌患者采用超低位前切除术（Dixon）、改良结肠肛管吻合术（改良 Parks）和 Miles 术式进行治疗。收集每位患者的术后肛门功能和粪便失禁生活质量量表（FIQL）评分，并进行综合分析。
与 Dixon 组相比，Parks 组患者术后肛门功能和 FIQL 在早期较差。然而，术后 6-12 个月，Parks 组肛门功能和 FIQL 评分与 Dixon 组相似（P>0.05）。与 Miles 组相比，两组术后早期 FIQL 相似。然而，随着时间的推移，术后 3-9 个月，Parks 组 FIQL 的四个维度逐渐高于 Miles 组（P<0.05）。
腹腔镜改良 Parks 是一种安全、有效、经济的保肛手术。虽然其早期肛门功能和 FIQL 较差，但可逐渐恢复至 Dixon 相似水平。此外，对于一些以前只能接受 Miles 手术的患者，它可以保留肛门并获得更好的术后生活质量。
