Xiang Hu1, Liang Cao, Jian Zhang, Pin Liang, Ge Liu. 1. Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, No. 222 Zhongshan Road, Dalian, 116011, China, caoliang913@163.com.
Abstract
OBJECTIVE: To evaluate the therapeutic results of abdominoperineal resections in the prone jackknife position for T3-4 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 ± 50.68 vs 210.67 ± 83.32 ml, P < 0.001) and shorter operation times (3.10 ± 1.08 vs 3.82 ± 1.43 h, p = 0.010) 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 < 0.001). By multivariate regression analysis, depth of tumor invasion (P = 0.032), CRM (P < 0.001), and position (P = 0.015) were found to be independent risk factors for local recurrence. Multivariate Cox regression survival analysis, lymph node metastasis, and CRM (P < 0.001) 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.
OBJECTIVE: To evaluate the therapeutic results of abdominoperineal resections in the prone jackknife position for T3-4 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 ± 50.68 vs 210.67 ± 83.32 ml, P < 0.001) and shorter operation times (3.10 ± 1.08 vs 3.82 ± 1.43 h, p = 0.010) 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 < 0.001). By multivariate regression analysis, depth of tumor invasion (P = 0.032), CRM (P < 0.001), and position (P = 0.015) were found to be independent risk factors for local recurrence. Multivariate Cox regression survival analysis, lymph node metastasis, and CRM (P < 0.001) were proven to be the major independent prognostic factors for T3-T4 low rectal cancerpatients. CONCLUSIONS: Abdominoperineal resection in the prone jackknife position for T3-T4 low rectal cancers is feasible and has a lower local recurrence.
Authors: Muhammad Tayyab; Abhiram Sharma; Joseph L Ragg; Alastair W Macdonald; James Gunn; John E Hartley; John R Monson Journal: Dis Colon Rectum Date: 2012-03 Impact factor: 4.585
Authors: Luiz Felipe de Campos-Lobato; Luca Stocchi; David W Dietz; Ian C Lavery; Victor W Fazio; Matthew F Kalady Journal: Dis Colon Rectum Date: 2011-08 Impact factor: 4.585
Authors: Ingrid S Martijnse; Ralph L Dudink; Nicholas P West; Dareczka Wasowicz; Grard A Nieuwenhuijzen; Ineke van Lijnschoten; Hendrik Martijn; Valery E Lemmens; Cornelis J van de Velde; Iris D Nagtegaal; Phil Quirke; Harm J Rutten Journal: Ann Surg Oncol Date: 2011-08-23 Impact factor: 5.344
Authors: Jose Wilson B Mesquita-Neto; Hassan Mouzaihem; Francisco Igor B Macedo; Lance K Heilbrun; Donald W Weaver; Steve Kim Journal: J Surg Oncol Date: 2019-02-06 Impact factor: 3.454