Therapeutic results of abdominoperineal resection in the prone jackknife position for T3-4 low rectal cancers.

Autor: Hu X; Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, No. 222 Zhongshan Road, Dalian, 116011, China, caoliang913@163.com., Cao L, Zhang J, Liang P, Liu G
Jazyk: angličtina
Zdroj: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract [J Gastrointest Surg] 2015 Mar; Vol. 19 (3), pp. 551-7. Date of Electronic Publication: 2014 Nov 04.
DOI: 10.1007/s11605-014-2683-1
Abstrakt: Objective: To evaluate the therapeutic results of abdominoperineal resections in the prone jackknife position for T3-4 low rectal cancers.
Methods: From January 2002 to January 2011, 536 patients with T3-T4 low rectal cancer underwent abdominoperineal resection. Two hundred forty-three were treated in the Lloyd-Davies position and 293 in the prone jackknife position. Clinicopathological data and survival of the two groups were analyzed retrospectively.
Results: Abdominoperineal resections in the prone jackknife position group were associated with significantly less blood loss (124 ± 50.68 vs 210.67 ± 83.32 ml, P < 0.001) and shorter operation times (3.10 ± 1.08 vs 3.82 ± 1.43 h, p = 0.010) than those in Lloyd-Davies position group. The total local recurrence rate is 8.4 % (45/536). The local recurrence rate in the prone jackknife position group was significantly lower than in the Lloyd-Davies position group (5.5 vs 11.9 %, P < 0.001). By multivariate regression analysis, depth of tumor invasion (P = 0.032), CRM (P < 0.001), and position (P = 0.015) were found to be independent risk factors for local recurrence. Multivariate Cox regression survival analysis, lymph node metastasis, and CRM (P < 0.001) were proven to be the major independent prognostic factors for T3-T4 low rectal cancer patients.
Conclusions: Abdominoperineal resection in the prone jackknife position for T3-T4 low rectal cancers is feasible and has a lower local recurrence.
Databáze: MEDLINE
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