Evaluation Of Pelvic Peritoneum Reconstruction In L-ELAPR For Low Rectal Cancer

ObjectiveLaparoscopic extralevator abdominoperineal resection (L-ELAPR) for low rectal cancer has been adopted by centers to improve oncological outcome. The present study aimed to evaluate the effectiveness of pelvic peritoneum reconstruction (PPR) in L-ELAPR for rectal carcinoma.MethodsConsecutive patients with low rectal cancer who underwent L-ELAPE from The First Affiliated Hospital of Kunming Medical University between March2012and March2014were included.They were divided into two group of34patients in PPR and without PPR during laparoscopic ELAPR. Data were collected from hospital records.The inclusion criteria were:preoperation line fiber colonoscopy; confirmed by pathology of rectal gland carcinoma, confirmed by fiber colonoscopy and anal diagnosis preoperatively edge of tumor from anal edge distance less than or equal to5cm; preoperative KPS score80points or more; preoperation assessment of clinical stage T1.2NOMO; operation are performed by the same surgery group, it is according to the successful implementation of the radical resection before L-ELAPR principle during operation; pre-operation without obstruction, tumor rupture bleeding, and so on, preoperation without basic diseases such as anemia、hypoproteinemia and cardiovascular and cerebrovascular diseases, preoperative neoadjuvant therapy. We observed in patients with postoperative ventilation time、postoperative hospital stay、perineal wound infection and dehiscence chance、perineal incision bleeding chance and chance of intestinal obstruction and internal hernia.ResultsThe group which received PPR is associated with shorter postoperative ventilation time (p<0.05) and hospital stay (p<0.05). No difference in perineal wound infection and dehiscence chance (p>0.05). perineal incision bleeding chance (p>0.05),and chance of intestinal obstruction and internal hernia.Conclusion(1) L-ELAPR surgery using2-0V-Loc180suture reconstruction pelvic peritoneum, shortened postoperative ventilation time、shorter postoperative hospital stay; further improved on the basis of the minimally invasive laparoscopic surgery postoperative recovery rate of patients have some clinical significance.(2) Postoperation complications, whether there are differences between two groups, pending further studies with larger sample volume.