Therapeutic Results of Abdominoperineal Resection in the Prone Jackknife Position for T3- Low Rectal Cancers

详细信息    查看全文

• 作者：Xiang Hu ; Liang Cao ; Jian Zhang ; Pin Liang ; Ge Liu
• 关键词：Rectal cancer ; Low ; Abdominoperineal resection ; Prone jackknife position ; Lloyd ; Davies position
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：19
• 期：3
• 页码：551-557
• 全文大小：813 KB
• 参考文献：1. MILES W. A method of performing abdominoperineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon. Lancet 1908;2:1812-813. 10.1016/S0140-6736(00)99076-7" target="_blank" title="It opens in new window">CrossRef
  2. OV L-D. Lithotomy-Trendelenburg position for resection of the rectum and lower pelvis colon. Lancet 1939; 234: 74-6. 10.1016/S0140-6736(00)61615-X" target="_blank" title="It opens in new window">CrossRef
  3. Bebenek M. Abdominosacral amputation of the rectum for low rectal cancers: ten years of experience. Ann Surg Oncol 2009;16:2211-217. 10.1245/s10434-009-0517-2" target="_blank" title="It opens in new window">CrossRef
  4. West NP, Anderin C, Smith KJ, Holm T, Quirke P and European Extralevator Abdominoperineal Excision Study G. Multicentre experience with extralevator abdominoperineal excision for low rectal cancer. Br J Surg 2010;97:588-99. 10.1002/bjs.6916" target="_blank" title="It opens in new window">CrossRef
  5. Tayyab M, Sharma A, Ragg JL, Macdonald AW, Gunn J, Hartley JE and Monson JR. Evaluation of the impact of implementing the prone jackknife position for the perineal phase of abdominoperineal excision of the rectum. Dis Colon Rectum 2012;55:316-21. 10.1097/DCR.0b013e31823e2424" target="_blank" title="It opens in new window">CrossRef
  6. de Campos-Lobato LF, Stocchi L, Dietz DW, Lavery IC, Fazio VW and Kalady MF. Prone or lithotomy positioning during an abdominoperineal resection for rectal cancer results in comparable oncologic outcomes. Dis Colon Rectum 2011;54:939-46. 10.1097/DCR.0b013e318221eb64" target="_blank" title="It opens in new window">CrossRef
  7. Martijnse IS, Dudink RL, West NP, Wasowicz D, Nieuwenhuijzen GA, van Lijnschoten I, Martijn H, Lemmens VE, van de Velde CJ, Nagtegaal ID, Quirke P and Rutten HJ. Focus on extralevator perineal dissection in supine position for low rectal cancer has led to better quality of surgery and oncologic outcome. Ann Surg Oncol 2012;19:786-93. 10.1245/s10434-011-2004-9" target="_blank" title="It opens in new window">CrossRef
  8. Keller DS, Lawrence JK and Delaney CP. Prone jackknife position is not necessary to achieve a cylindrical abdominoperineal resection: demonstration of the lithotomy position. Dis Colon Rectum 2014;57:251. 10.1097/DCR.0000000000000047" target="_blank" title="It opens in new window">CrossRef
  9. Quirke P, Durdey P, Dixon MF and Williams NS. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision. Lancet 1986;2:996-99. 10.1016/S0140-6736(86)92612-7" target="_blank" title="It opens in new window">CrossRef
  10. How P, Shihab O, Tekkis P, Brown G, Quirke P, Heald R and Moran B. A systematic review of cancer related patient outcomes after anterior resection and abdominoperineal excision for rectal cancer in the total mesorectal excision era. Surg Oncol 2011;20:e149-55. 10.1016/j.suronc.2011.05.001" target="_blank" title="It opens in new window">CrossRef
  11. K L. Die sacro-abdominale mastdarm-exstirpation. Chirurg 1941;13:511-17.
  12. KH B. Uber die sacro-abdominelle rectum exstirpation. Chirurg 1952;23:145-50.
  13. Holm T, Ljung A, Haggmark T, Jurell G and Lagergren J. Extended abdominoperineal resection with gluteus maximus flap reconstruction of the pelvic floor for rectal cancer. Br J Surg 2007;94:232-38. 10.1002/bjs.5489" target="_blank" title="It opens in new window">CrossRef
  14. den Dulk M, Putter H, Collette L, Marijnen CA, Folkesson J, Bosset JF, Rodel C, Bujko K, Pahlman L and van de Velde CJ. The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of five European randomised clinical trials on rectal cancer. Eur J Cancer 2009;45:1175-183. 10.1016/j.ejca.2008.11.039" target="_blank" title="It opens in new window">CrossRef
  15. Han JG, Wang ZJ, Wei GH, Gao ZG, Yang Y and Zhao BC. Randomized clinical trial of conventional versus cylindrical abdominoperineal resection for locally advanced lower rectal cancer. Am J Surg 2012;204:274-82. 10.1016/j.amjsurg.2012.05.001" target="_blank" title="It opens in new window">CrossRef
  16. Stelzner S, Hellmich G, Schubert C, Puffer E, Haroske G and Witzigmann H. Short-term outcome of extra-l
• 刊物主题：Surgery; Gastroenterology;
• 出版者：Springer US
• ISSN：1873-4626

文摘

Objective To evaluate the therapeutic results of abdominoperineal resections in the prone jackknife position for T3- low rectal cancers. Methods From January 2002 to January 2011, 536 patients with T3–T4 low rectal cancer underwent abdominoperineal resection. Two hundred forty-three were treated in the Lloyd-Davies position and 293 in the prone jackknife position. Clinicopathological data and survival of the two groups were analyzed retrospectively. Results Abdominoperineal resections in the prone jackknife position group were associated with significantly less blood loss (124?±-0.68 vs 210.67?±-3.32?ml, P--.001) and shorter operation times (3.10?±-.08 vs 3.82?±-.43?h, p--.010) than those in Lloyd-Davies position group. The total local recurrence rate is 8.4?% (45/536). The local recurrence rate in the prone jackknife position group was significantly lower than in the Lloyd-Davies position group (5.5 vs 11.9?%, P--.001). By multivariate regression analysis, depth of tumor invasion (P--.032), CRM (P--.001), and position (P--.015) were found to be independent risk factors for local recurrence. Multivariate Cox regression survival analysis, lymph node metastasis, and CRM (P--.001) were proven to be the major independent prognostic factors for T3–T4 low rectal cancer patients. Conclusions Abdominoperineal resection in the prone jackknife position for T3–T4 low rectal cancers is feasible and has a lower local recurrence.