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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2018, Vol. 12 ›› Issue (05): 445-447. doi: 10.3877/cma.j.issn.1674-3946.2018.05.027

Special Issue:

• Original Article • Previous Articles     Next Articles

Influence of surgical approach on therapeutic effect and safety for middle-aged and elderly patients with DAV ≤8.0 cm rectal cancer of T1 stage

Sheng Wei1,(), Chujie Ou1, Haibing Ye1   

  1. 1. Department of general surgery, Xishui Hospital of Traditional Chinese Medicine, Xishui Country, 438200, China
  • Received:2018-04-07 Online:2018-10-26 Published:2018-10-26
  • Contact: Sheng Wei
  • About author:
    Corresponding author: Wei Sheng, Email:

Abstract:

Objective

To explore the influence of surgical approach on therapeutic effect and safety for middle-aged and elderly patients with distance from anal verge (DAV) ≤8.0 cm rectal cancer of T1 stage.

Methods

The clinical data of 76 cases with distance from anal verge (DAV) ≤8.0 cm rectal cancer of T1 stage treated in our hospital from January 2012 to January 2014 were collected and retrospectively analyzed. According to different surgical approaches, the patients were divided into the transanal excision group (39 cases, undergoing transanal local resection) and the radical excision group (37 cases, undergoing radical resection). All data were analyzed by SPSS 20.0 statistical software. The intraoperative and postoperative related indicators were presented as (±s) and were compared by t test. The incidence of postoperative complications and death were presented as [n (%)]] and were compared by chi square.

Results

All patients of two groups were successfully completed the surgery. Compared with the radical excision group, the operation time in the transanal excision group was significantly shortened, the intraoperative blood loss in the transanal excision group was significantly decreased, the postoperative first feeding time, first exhaust time, drainage time, length of stay in the transanal excision group were significantly shortened, the rate of totally postoperative complications, especially lung infection, in the transanal excision group were significantly decreased, and the anus incontinence and sexual dysfunction incidence within 3 years after operation in the transanal excision group were significantly decreased (P<0.05). There was no statistical difference in the rate of mortality, recurrence rate and metastasis between two groups (P>0.05).

Conclusion

The transanal local resection in treatment for middle-aged and elderly patients with DAV ≤8.0 cm rectal cancer of T1 stage is consistent with the radical excision in therapeutic effect and prognosis, and the protection of defecation and sexual functions in transanal local resection is superior to those in radical excision.

Key words: Rectal Neoplasms, DAV≤8.0 cm, Laparotomy, Treatment Outcome, Comparative Study

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