The Clinical Efficacy Of Application Of Laparoscopic Extralevator Abdominoperineal Excision For Low Advanced Rectal Carcinoma

Objective:At present,the abdominal perineal resection is the first choice for the treatment of low rectal cancer,but it still has a high rate of circumferential resection margin and a perforation,which affects the survival rate of patients after 5 years.Therefore,the extralevator abdominoperineal excision is highly praised at home and abroad,but the effect needs to be further verified after the operation.The purpose of this study is to report the feasibility of the application of Laparoscopic extralevator abdominoperineal excision in the treatment of low rectal cancer.Methods:The clinical data of 106 patients with low rectal cancer in our hospital from January 2013 to December 2015 were analyzed retrospectively.The clinical data of patients with low rectal cancer(less than or equal to 5cm)were treated by surgical treatment.47 cases of patients underwent laparoscopic abdominoperineal excision,and 59 cases of patients underwent laparoscopic extralevator abdominoperineal excision.By using statistical method,the indexes of the two groups were analyzed.Results:The circumferential resection margin rate of LELAPE groups is lower than the LAPE group(1.69%vs 17.02%,χ~2=7.909),and perineal incision infection rate of LELAPE groups is also lower than the LAPE group(3.40%vs 19.14%,χ~2=6.986),the differences were statistically significant(P<0.05).The perforation rate(1.69%vs6.38%,χ~2=1.583)and operative time(χ~2=0.849)and intraoperative blood loss(χ~2=0.921)and the number of lymph node dissections(χ~2=0.670)and postoperative C reactive protein(t=1.483)and interleukin 6(t=0.560)and hospital stay(χ~2=0.635)in patients were not statistically significant(P>0.05).Conclusion:Laparoscopic abdominal perineal resection of the joint by anus levator relative to laparoscopic abdominal perineal resection of the joint with lower circumferential cut edge positive rate and perineum incision infection rate advantage,and in intraoperative and postoperative perforation rate there is no statistical difference of inflammation,laparoscopic via anus levator combination of abdominal perineal resection is safe and feasible,can be popularized in clinic.