Analysis Of The Principle For The Radical Resection Of Rectal Cancer

ObjectiveTo investigate the choise of different types of rectal cancer and its effect for choosing the best surgical procedures and treatment programs to provide theoretical support.Methods1 Retrospective analysis of our hospital from January 2006 to December 2009 to preserve the anal sphincter of the 148 rectal cancer cases. The patient's sex, age, tumor distance from the anal margin, histological type, stage, postoperative complications such as anastomotic leakage, anastomotic stenosis, anastomotic bleeding, wound infection were statistically analyzed.2 Follow-up Through outpatient and telephone.3 Count data between the groups usingχ2 test the existence of (n <40 when using Fisher's exact test), and use statistical packages to analyze the use SPSS16.0.Result1 According to postoperative pathology results, the surgical pathology as follows: 48 cases of high differentiated adenocarcinoma, 22 cases of high-moderately differentiated adenocarcinoma, 66 cases of moderately differentiated adenocarcinoma, 4 cases of moderately-poorly differentiated adenocarcinoma, poorly differentiated adenocarcinoma 5 cases, others such as mucinous adenocarcinoma, papillary adenocarcinoma in 3 cases. Highly differentiated, high-moderately differentiation, moderately differentiated adenocarcinoma accounted for 91.9% (136/148). Dixon technique which uses 134 cases, accounting for 90.5% of the total number of surgical patients (134/148), see Dixon rectal resection surgery accounted for the main status.2 Dukes stage: A period :39 cases, B period :52 cases, C period (including C1, C2) 43 cases, D of 14 cases, D of preoperative imaging diagnosis is not invading the surrounding organs, distant metastasis ( liver). Although some patients have reached Dukes D period, but we can still radical surgery to reduce the local recurrence rate, after mentioning the high quality of life.3 Selected cases underwent Dixon + PANP + TME surgery, 72 patients (below Peritoneal cancer), accounting for 48.6% of the total number of surgical patients (72/148). One line of Dixon + PANP + TME + LLD were 28 cases. OK PANP + TME + Pulling out the external anal anastomosis in 2 patients, accounting for 1.4% of the total number of surgical patients (2 / 148), line Dixon + PANP surgery in 62 cases (more than Peritoneal Cancer), representing the total number of surgical patients 41.9% (62/148), radical local excision in 2 cases accounted for 1.4% of the total number of surgical patients (2 / 148), tumor excision alone in 10 cases accounted for 6.8% of the total number of surgical patients (10/148) .4 Selected cases have occurred in 4 cases of anastomotic leakage, the total number of operations 2.7% (4 / 148) Which occurred at 3-5cm in 3 cases, the total number of operations 2.0% (3 / 148) in 5-7cm in 1 case, the total number of operations 0.8% (1 / 148). There is no anastomotic leakage in 7-9cm and 9-15cm .Conclusion1 To preserve the anus on rectal cancer patients should be based on different conditions, choose the most beneficial surgical procedures, more than Peritoneal line Dixon + TME surgery, the following line Peritoneal Dixon + TME + PANP surgery, lateral lymph node dissection is not routine. Feasible for patients with low rectal cancer rectal rectal pull double stapling surgery, consistent with local excision for early cancer via the anus or abdominal local excision and radical purposes.2 Stapler application can improve the low and ultra low rectal cancer.3 Neoadjuvant treatment of rectal cancer can increase the chance.4 Department in the anal sphincter may have "functional anal verge".