A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation
Objective: The objective is to investigate if laparoscopic-dominant abdominoperineal resection (LDAPR) with individualised levator ani resection inhibits local recurrence (LR) and prolongs survival as compared to laparoscopic abdominoperineal resection (APR). Materials and Methods: Rectal cancer sur...
| Principais autores: | , , , , , , |
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| Formato: | Artigo |
| Idioma: | English |
| Publicado em: |
Wolters Kluwer Medknow Publications
2024-01-01
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| coleção: | Journal of Minimal Access Surgery |
| Assuntos: | |
| Acesso em linha: | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=55;epage=61;aulast=Xue |
| _version_ | 1827293166339883008 |
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| author | Xiajuan Xue Chao Jian Yicong Fang Lixiong Luo Yinzong Guo Bijuan Ling Mingzhi Cai |
| author_facet | Xiajuan Xue Chao Jian Yicong Fang Lixiong Luo Yinzong Guo Bijuan Ling Mingzhi Cai |
| author_sort | Xiajuan Xue |
| collection | DOAJ |
| description | Objective: The objective is to investigate if laparoscopic-dominant abdominoperineal resection (LDAPR) with individualised levator ani resection inhibits local recurrence (LR) and prolongs survival as compared to laparoscopic abdominoperineal resection (APR).
Materials and Methods: Rectal cancer surgery cases were retrospectively identified from September 2014 to December 2019. LDAPR-treated group (55 patients) and the APR-treated group (71 patients) were included in the study. The operation time, circumferential resection margin (CRM), intraoperative tumor surgery (ITP), post-operative complications, the 2-year overall survival (OS) and LR were compared in the two groups.
Results: The CRM and ITP were significantly reduced in the LDAPR as compared to the APR group (3.6% vs. 16.9%, t = 5.522, P = 0.019; 3.6% vs. 14.1%, t = 3.926, P = 0.048). In terms of post-operative complications, the incidence of urinary retention in LDAPR was significantly reduced than the APR group (10.9% vs. 25.4%, χ2 = 4.139, P = 0.041). Similarly, perineal pain at 6 months or 1 year after surgery was significantly down-regulated in LDAPR than in the APR group (72.7% vs. 88.7%, χ2 = 5.320, P = 0.021; 18.2% vs. 43.2%, χ2 = 8.288, P = 0.004). However, there was no statistically significant difference in the post-operative complications between the LDAPR and APR groups. Finally, LDAPR led to a significantly improved 2-year OS and a reduced LR compared to APR.
Conclusion: LDAPR reduces CMR, ITP and LR and simplified the perineum operation, subsequently protecting the pelvic autonomic nerves. Compared to the conventional APR, LDAPR is a promising procedure worth adopting for rectal cancer treatment. |
| first_indexed | 2024-03-07T21:35:49Z |
| format | Article |
| id | doaj.art-9a3243900d4e489493289cacf7f4a7de |
| institution | Directory Open Access Journal |
| issn | 0972-9941 1998-3921 |
| language | English |
| last_indexed | 2024-04-24T13:20:36Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj.art-9a3243900d4e489493289cacf7f4a7de2024-04-04T16:19:15ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212024-01-01201556110.4103/jmas.jmas_168_22A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigationXiajuan XueChao JianYicong FangLixiong LuoYinzong GuoBijuan LingMingzhi CaiObjective: The objective is to investigate if laparoscopic-dominant abdominoperineal resection (LDAPR) with individualised levator ani resection inhibits local recurrence (LR) and prolongs survival as compared to laparoscopic abdominoperineal resection (APR). Materials and Methods: Rectal cancer surgery cases were retrospectively identified from September 2014 to December 2019. LDAPR-treated group (55 patients) and the APR-treated group (71 patients) were included in the study. The operation time, circumferential resection margin (CRM), intraoperative tumor surgery (ITP), post-operative complications, the 2-year overall survival (OS) and LR were compared in the two groups. Results: The CRM and ITP were significantly reduced in the LDAPR as compared to the APR group (3.6% vs. 16.9%, t = 5.522, P = 0.019; 3.6% vs. 14.1%, t = 3.926, P = 0.048). In terms of post-operative complications, the incidence of urinary retention in LDAPR was significantly reduced than the APR group (10.9% vs. 25.4%, χ2 = 4.139, P = 0.041). Similarly, perineal pain at 6 months or 1 year after surgery was significantly down-regulated in LDAPR than in the APR group (72.7% vs. 88.7%, χ2 = 5.320, P = 0.021; 18.2% vs. 43.2%, χ2 = 8.288, P = 0.004). However, there was no statistically significant difference in the post-operative complications between the LDAPR and APR groups. Finally, LDAPR led to a significantly improved 2-year OS and a reduced LR compared to APR. Conclusion: LDAPR reduces CMR, ITP and LR and simplified the perineum operation, subsequently protecting the pelvic autonomic nerves. Compared to the conventional APR, LDAPR is a promising procedure worth adopting for rectal cancer treatment.http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=55;epage=61;aulast=Xueabdominoperineal resectionindividualised levator ani resectionlocal recurrencelow rectal canceroverall survival |
| spellingShingle | Xiajuan Xue Chao Jian Yicong Fang Lixiong Luo Yinzong Guo Bijuan Ling Mingzhi Cai A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation Journal of Minimal Access Surgery abdominoperineal resection individualised levator ani resection local recurrence low rectal cancer overall survival |
| title | A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation |
| title_full | A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation |
| title_fullStr | A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation |
| title_full_unstemmed | A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation |
| title_short | A short-term study of laparoscopic-dominant individualised levator ani resection in abdominoperineal resection: A retrospective investigation |
| title_sort | short term study of laparoscopic dominant individualised levator ani resection in abdominoperineal resection a retrospective investigation |
| topic | abdominoperineal resection individualised levator ani resection local recurrence low rectal cancer overall survival |
| url | http://www.journalofmas.com/article.asp?issn=0972-9941;year=2024;volume=20;issue=1;spage=55;epage=61;aulast=Xue |
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