The Effectivity of Laparoscopic-Dominant Individualized Levator-Ani Resection: A Retrospective Study

Xiajuan Xue, Chao Jian, Yicong Fang, Lixiong Luo, Yinzong Guo, Bijuan Ling and Mingzhi Cai

Department of Colorectal Surgery, Zhangzhou Municipal Hospital Affiliated of Fujian Medical University, China Internal Medicine ICU, Zhangzhou Municipal Hospital Affiliated of Fujian Medical University, China Department of Surgery, Zhangzhou Municipal Hospital Affiliated of Fujian Medical University, China

^*Correspondance to: Mingzhi Cai 

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Abstract:

Abstract Objective: To investigate if Laparoscopic-Dominant Abdominoperineal Resection with individualized levator-ani resection (LDAPR) inhibits local recurrence and prolongs survival compared to Laparoscopic Abdominoperineal Resection (APR). Methods: Rectal cancer surgery cases were retrospectively identified from September 2014 to December 2019. LDAPR treated group (55 patients) and the APR-treated group (71 patients) were included in the study. The operation time, Circumferential Resection Margin (CRM), Intraoperative tumor Perforation (IOP), postoperative complications, the two-year overall survival and local recurrence were compared in the two groups. Results: The CRM and IOP were significantly reduced in the LDAPR compared to the APR group (3.6% vs. 16.9%, t=5.522, P=0.019; 3.6% vs. 14.1%, t=3.926, P=0.048). In terms of postoperative complications, the incidence of urinary retention in LDAPR was significantly reduced than the APR group (10.9% vs. 25.4%, χ2=4.139, P=0.041). Similarly, perineal pain at 6 months or 1 year after surgery was significantly down-regulated in LDAPR than in the APR group (72.7% vs. 88.7%, χ2=5.320, P=0.021; 18.2% vs. 43.2%, χ2=8.288, P=0.004. However, there was no statistically significant difference in the postoperative complications between the LDAPR and APR groups. Finally, LDAPR led to a significantly improved two-year overall survival and a reduced local recurrence compared to APR. Conclusion: LDAPR reduce CMR, IOP, and local recurrence and simplified the perineum operation, subsequently protecting the pelvic autonomic nerves. Compared to the conventional APR, LDAPR is a promising procedure worth adopting for rectal cancer treatment.

Keywords:

Keywords: Abdominoperineal resection; Individualized levator-ani resection; Local recurrence; Low rectal cancer

Cite the Article:

Xue X, Jian C, Fang Y, Luo L, Guo Y, Ling B, et al. The Effectivity of Laparoscopic-Dominant Individualized Levator-Ani Resection: A Retrospective Study. World J Surg Surgical Res. 2022; 5: 1406..