Randomized clinical trial of conventional versus cylindrical abdominoperineal resection for locally advanced lower rectal cancer
Randomized clinical trial of conventional versus cylindrical abdominoperineal resection for locally advanced lower rectal cancer
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传统与圆柱形腹会阴切除术治疗局部晚期低位直肠癌的随机临床试验
DOI：
10.1016/j.amjsurg.2012.05.001
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发表时间：
2012-09-01
影响因子：
3
通讯作者：
Zhao, Bao Cheng
中科院分区：
文献类型：
--
作者：
Han, Jia Gang;Wang, Zhen Jun;Zhao, Bao Cheng
背景：低位直肠癌的另一种治疗方法是柱状技术。我们的目的是比较接受常规腹会阴切除术（APR）和圆柱形APR的患者的结果。方法：2008年1月至2010年12月进行了一项前瞻性、随机、开放标签、平行对照试验。研究期间共确诊T3-T4低位直肠癌患者67例（常规n = 32，柱形n = 35）。结果：行圆柱形APR的患者会阴部分手术时间短（P < 0.001），会阴缺损大（P < 0.001），术中出血量少（P = 0.001），总横截组织面积大（P < 0.001），总手术时间相近（P = 0.096），会阴疼痛发生率高（P < 0.001）。圆柱形APR组局部复发率有统计学意义（P = 0.048）。结论：与传统取石位APR相比，俯卧叠刀位圆柱形APR治疗低位直肠癌可降低局部复发风险，且并发症不增加。(C) 2012爱思唯尔公司版权所有。
BACKGROUND: An alternative treatment for low rectal cancer is the cylindrical technique. We aim to compare the outcomes of patients undergoing conventional abdominoperineal resection (APR) versus cylindrical APR.METHODS: A prospective, randomized, open-label, parallel controlled trial was conducted between January 2008 and December 2010. Sixty-seven patients with T3-T4 low rectal cancer were identified during the study period (conventional n = 32, cylindrical n = 35).RESULTS: Patients who received cylindrical APR had less operative time for the perineal portion (P < .001), larger perineal defect (P < .001), less intraoperative blood loss (P = .001), larger total cross-sectional tissue area (P < .001), similar total operative time (P = .096), and more incidence of perineal pain (P < .001). The local recurrence of the cylindrical APR group was improved statistically (P = .048).CONCLUSIONS: Cylindrical APR in the prone jackknife position has the potential to reduce the risk of local recurrence without increased complications when compared with conventional APR in the lithotomy position for the treatment of low rectal cancer. (C) 2012 Elsevier Inc. All rights reserved.