Laparoscopic surgical options for ultralow rectal cancer and observed postoperative quality of life

doi:10.3877/cma.j.issn.2095-3224.2017.01.010

Abstract

Abstract:

Objective

To discuss the laparoscopic surgery procedure of ultra-low rectal cancer and postoperative quality of life.

Methods

24 cases of super low rectal cancer treated by general surgery in Suqian People?s Hospital of Nanjing Drum Tower Hospital from 2013 to 2015 were treated with laparoscopic assisted abdominoperineal nealresection (APR), laparoscopic assisted anal in situ re-laparoscopy combined with sacrococcygeal approach, postoperative quality of life evaluation Wexner score and stool quality of life questionnaire. Data were compared between non-parametric test, in which multiple groups of independent samples are more commonly used K-WH test.

Results

All patients underwent successful operation, and the margins of resection margin, circumcision margin and lymph node count accorded with tumor safety index of rectal cancer. Wexner score showed significant difference between the 3th month, 6th month and 9th month after operation (H=6.388, 8.246, 6.563, P=0.043, 0.021, 0.044). The fecal incontinence quality of life questionnaire in the 9th month after operation, the difference in the three groups was statistically significant (H= 4.568, 6.342, 5.479, 7.236, P=0.024, 0.015, 0.047, 0.031). The sacrococcygeal surgery group, the indicators of the questionnaire close to normal.

Conclusion

Laparoscopic ultra-low rectal cancer surgery is feasible by the sacral anus, postoperative quality of life was improved significantly than other treatment groups.

Key words: Laparoscopes, Rectal neoplasms, Surgical procedures, Quality of life

Xinqiang Zhu, Ming Zhang, Chuang Ding, Lingyong Kong, Yan Chen, Wenxian Guan. Laparoscopic surgical options for ultralow rectal cancer and observed postoperative quality of life[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(01): 46-51.

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References 30

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失禁情况	频率
失禁情况	从不	很少	有时	常常	总是
干便	0	1	2	3	4
稀便	0	1	2	3	4
气体	0	1	2	3	4
需要衬垫	0	1	2	3	4
生活方式改变	0	1	2	3	4

失禁情况	频率
失禁情况	从不	很少	有时	常常	总是
干便	0	1	2	3	4
稀便	0	1	2	3	4
气体	0	1	2	3	4
需要衬垫	0	1	2	3	4
生活方式改变	0	1	2	3	4

术式	术后3个月	术后6个月	术后9个月
APR	11.3±0.4（7~15）	6.8±0.3（4~13）	6.5±0.6（4~11）
原位再造	9.5±0.3（8~14）	8.7±0.2（6~11）	7.3±0.3（6~10）
经骶尾组	7.8±0.4（6~9）	5.4±0.2（4~8）	4.7±0.2（3~7）
H值	6.388	8.246	6.563
P值	0.043	0.021	0.044

术式	术后3个月	术后6个月	术后9个月
APR	11.3±0.4（7~15）	6.8±0.3（4~13）	6.5±0.6（4~11）
原位再造	9.5±0.3（8~14）	8.7±0.2（6~11）	7.3±0.3（6~10）
经骶尾组	7.8±0.4（6~9）	5.4±0.2（4~8）	4.7±0.2（3~7）
H值	6.388	8.246	6.563
P值	0.043	0.021	0.044

术式	生活方式	心里应付/行为	抑郁/自我感受	窘迫尴尬
APR	2.8±0.8	2.7±0.6	2.9±0.9	2.5±0.6
原位再造	2.6±0.8	2.8±0.9	2.9±0.8	2.1±0.6
经骶尾组	3.3±0.9	3.4±0.8	3.6±0.9	3.5±0.8
H值	4.568	6.342	5.479	7.236
P值	0.024	0.015	0.047	0.031

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