The Clinical Value Of The Reconstruction Of Pelvic Peritoneal In Laparoscopic Assisted Miles

Objective: aparoscopic assisted Miles for the patients of low rectal cancer who had been adopted by centers to improve oncological outcomes of surgery.The aim of the present study is to evaluate the clinical value of pelvic peritoneum reconstruction in Laparoscopic assisted Miles.Methods: Uninterrupted patients with low rectal cancer.All of these patients underwent Laparoscopic assisted Miles in the department of surgery of The Second Affiliated Hospital of Jiling University between June 2015 and December 2016 were included.We divided the patients into two groups,according to whether they had adopted the reconstruction of the pelvic peritoneal.There were 25 patients are the experimental group and the other 23 patients are in the contrast group(without the reconstruction of pelvic peritoneal).All the datas were collected from hospital records.The standard set is: The patients whose tumer edge to the anal verge is less than 5cm and checked by electrical colonscope;except those patients with acute intestinal obstruction,liver and lung metastasis,and those patients who underwent neoadjuvant radiotherapy and chemotherapy before the surgery.The pathology test had confirmed to be rectal adenocarcinoma;confirmed by pathology of rectal gland carcinoma;the preoperative KPS scores 80 points or more;Operation of the patients were performed by the same surgery group of professor Tong jun Liu.Duringoperation,the surgery was according to the successful implementation of the radical resection before the Laparoscopic assisted Miles principle.Exclusion criteria:the obstruction,tumor rupture bleedingand so on.The patients with basic diseases such as anemia hypoproteinemia and cardiovascular and the acerebrovascular diseases and preoperative neoadjuvant therapy are excluded.We researched in the patients with the incidence of Radioactive enteritis and the chance of intestinal obstruction?and perineal wound infection?postoperative hospital stay?and the dehiscence chance?the healing of perineal incision.Results: 1.Comparison of the incidence of Intestinal obstruction and Radiational small enteritis : there was not one case of twenty-five patients developed Intestinal obstruction in the group which had received the pelvic peritoneum reconstruction,the incidence rate was 0.0%,While,The number of the contrast group was 17.4%,with four cases in twenty-three patients.p=0.029<0.05.The three cases with Intestinal obstruction had slight symptoms and restored to health with a short-term expectant treatment.one case of patients in the contrast group resumed after expectant treatment,the other one in the same group got rehabilitation through surgery.Two groups of data had statistical significance.There were nine patients having postoperative radiotherapy of the twenty-five patients who had received the pelvic peritoneum reconstruction,one patient of them had radiational small enteritis.The ratewas 11.1%,but the data of the patients in contrast group was 57.1%,p=0.049<0.05.the reconstruction of pelvic peritoneal in Laparoscopic assisted Miles significantly reduced the incidence of Intestinal obstruction and Radiational small enteritis after the rectal cancer surgery.the patients who had received the reconstruction of pelvic peritoneal were associated with shorter postoperative exhaust time(p<0.05),but the similiar hospital stay(p>0.05).There was no difference in the perineal wound infection and no difference in the dehiscence chance(p>0.05).Also,there was no significant difference in the time of surgery between the two groups.Conclusion: 1.Using the Quill line in the Laparoscopic assisted Miles to reconstruct the pelvic peritoneum can reduce the incidence of Intestinal obstruction and radiational small enteritis.It can short the postoperative exhaust time.However,it can not short postoperative hospital stay;it can not short the incidence of incisional wound;PPR Further improved the results on the basis of the minimally invasive laparoscopic surgery postoperative recovery rate of patients,and it had some clinical significance.2.The using of Quill line makes the reconstruction of pelvic peritoneal easier than before.3.whether there are differences between two groups in the postoperation complications,pending further studies with greater amounts of samples.