Therapeutic Effects Of Cylindrical Abdominoperineal Resection For Locally Advanced Or Low Rectal Cancer

Objective:To investigate the therapeutic effects of cylindrical abdominoperineal resection (CAPR)and abdominoperineal resection (APR) for locally advanced or low rectal cancer.Methods:Between March 2009 and January 2014,112 patients with low rectal cancer were treated with CAPR or APR at the Qilu Hospital of Shandong University, of which 62 were operated with CAPR treatment and 50 cases with APR treatment. All patients’data on treatment and follow-up were recorded and analysed detailedly.Results:The average operation time was 200.21±23.65min in CAPR group and 191.33±56.71min in APR group.The average amount of bleeding was 170.32±83.95ml in CAPR group and 168.32±74.25ml in APR group.The average time of presacral drainage tube removal was 9.5±4.4d in CAPR group and 8.9±3.6d in APR group.There were no statistical differences in two groups(P> 0.05).Intra-operative perforation occurred in 0 and 7 patients(0 and 14.00%) respectively in two groups,there was statistical difference (P=0.002).Histopathology revealed a positive CRM occurred respectively in 5 and 11 patients (8.06% and 22.00%),there was statistical difference(P=0.036).Until December 2014 [median follow-up 45.8 (3-69) months]local recurrence was detected respectively in 4 and 10 patients(6.45% and 20.00%),there was statistical difference(P=0.036). Five-year overall survival was estimated to 62% and 51%,there was no statistical difference(P=0.32).Conclusions:Good intra-operative tumour perforation、positive CRM、local recurrence and overall survival may be achieved with CAPR in patients with low, advanced rectal cancer.