Department of General Surgery, The First Affiliated Hospital of Dali University, No.32 Jia Shi Bai Avenue, Dali, 671000, China.
Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Updates Surg. 2023 Apr;75(3):611-617. doi: 10.1007/s13304-023-01466-y. Epub 2023 Mar 4.
This study was performed to retrospectively analyze and compare the related clinical indicators between extralevator abdominoperineal excision (ELAPE) and non-ELAPE under laparoscopic for low rectal cancer. From June 2018 to September 2021, a total of 80 patients with low rectal cancer who underwent either of the above two types of surgeries at our Hospital were enrolled. Patients were divided into the ELAPE group and non-ELAPE group based on the different surgical methods. Preoperative general indicators, intraoperative indicators, postoperative complications, positive circumferential resection margin rate, local recurrence rate, hospital stay length, hospital expenses, and other related indicators were compared between the two groups. There were no significant differences in the comparison of preoperative indexes between the ELAPE group and non-ELAPE group, including age, preoperative BMI, and gender. Similarly, there were no significant differences in abdominal operation time, total operation time, and the number of intraoperative lymph nodes dissected between the two groups. However, the perineal operation time, intraoperative blood loss, intraoperative perforation rate, and positive circumferential resection margin rate were significantly different between the two groups. In the comparison of postoperative indexes, perineal complications, postoperative hospital stay length, and IPSS score were significantly different between the two groups. The use of ELAPE in treating T3-4NxM0 phase low rectal cancer was superior to non-ELAPE in reducing intraoperative perforation rate, positive circumferential resection margin rate, local recurrence rate, etc.
本研究回顾性分析比较了腹腔镜低位直肠癌根治术中经括约肌间切除(ISR)与超低位前切除(ELAPE)的相关临床指标。2018 年 6 月至 2021 年 9 月,我院收治的 80 例低位直肠癌患者分别采用以上两种手术方式,根据手术方式的不同分为 ISR 组和 ELAPE 组,比较两组患者的术前一般指标、术中指标、术后并发症、环周切缘阳性率、局部复发率、住院时间、住院费用等相关指标。ELAPE 组与 ISR 组在年龄、术前 BMI、性别等术前指标比较差异无统计学意义,两组患者的腹部手术时间、总手术时间、术中清扫淋巴结个数比较差异无统计学意义,但两组患者的会阴部手术时间、术中出血量、术中穿孔率、环周切缘阳性率比较差异有统计学意义。术后指标中,两组患者的会阴部并发症、术后住院时间、IPSS 评分比较差异有统计学意义。ELAPE 治疗 T3-4NxM0 期低位直肠癌可降低术中穿孔率、环周切缘阳性率、局部复发率等。