Objective To study the safety and feasibility of modified laparoscopic Dixon surgery for rectal cancer.
Methods In the procedure of modified laparoscopic Dixon surgery, the rectum with tumor was pulled out and cut and colon-rectum anastomosis was performed through anus. The clinical data of patients with rectal cancer between modified laparoscopic Dixon surgery (laparoscopy group) and open Dixon surgery (open group) were compared and analysed prospectively. The clinical data included operative time, volume of bleeding, number of lymph node dissection, volume of abdominal drainage, time to bowel gas passage, hospital stay and relative complications, such as anastomotic leakage, ureteral injury, dysuria and fecal incontinence.
Results Fifty-eight cases were selected in this study between September 2007 and July 2008, including 25 laparoscopic surgery in laparoscopy group and 33 open surgery in open group. Patient’s data on gender, age, distance between tumor and anus edge, tumor diameter, tumor pathologic type and Dukes stage were similar between two groups by statistic analysis (P gt;0.05). All the operations were performed successfully. Two cases experienced anastomotic leakage in laparoscopy group, while 1 case experienced anastomotic leakage in open group. All these patients got recovered by conservative treatment at last. No other complications were experienced, such as ureteral injury, dysuria, fecal incontinence, and so on. There were no significant differences in term of operative time, volume of bleeding and number of lymph node dissection between two groups (P gt;0.05). The volume of abdominal drainage was less while the time to bowel gas passage and hospital stay were shorter in laparoscopy group than those in open group (P＜0.05).
Conclusion This study reveals that it is safe and feasible to perform modified laparoscopic Dixon surgery for rectal cancer, and it presents the character of minimal invasion.
Citation：
WU Dongbo,HUANG Shunrong,WU Honggen,ZHOU Ming,DENG Hongqiang,PAN Yun. Comparison of Clinical Course Between Modified Laparoscopic Dixon Surgery and Open Dixon Surgery for Rectal Cancer with 58 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(3): 211-214. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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- 1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy) [Ｊ]. Surg Laparosc Endosc, 1991; 1(3):144.
- 2. 王存川. 腹腔镜直肠全系膜切除保肛术 [Ａ]. 见： 王存川主编. 实用腹腔镜外科手术学 [M]. 第1版. 广州： 暨南大学出版社, 2002∶191～196.
- 3. 汪建平. 直肠癌手术 [Ａ]. 见： 汪建平, 詹文华主编. 胃肠外科手术学 [M]. 第1版. 北京: 人民卫生出版社, 2005∶895~906.
- 4. 池肇春主编. 实用临床胃肠病学 [M]. 第1版. 北京: 中国医药科技出版社, 2001∶〖ＫＧ-*５〗985~987.
- 5. Aziz O, Constantinides V, Tekkis PP, et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis [Ｊ]. Ann Surg Oncol, 2006; 13(3):413.
- 6. Bruch HP, Esnaashari H, Schwandner O. Current status of laparoscopic therapy of colorectal cancer [Ｊ]. Dig Dis, 2005; 23(2):127.
- 7. Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer [Ｊ]. N Engl J Med, 2004; 350(20):2050.
- 8. Kuhry E, Schwenk WF, Gaupset R, et al. Long-term results of laparoscopic colorectal cancer resection [Ｊ]. Cochrane Database Syst Rev, 2008; 16(2):CD003432.
- 9. Polliand C, Barrat C, Champault G. Laparoscopic resection of low rectal cancer with a mean follow-up of seven years [Ｊ]. Surg Laparosc Endosc Percutan Tech, 2005; 15(3):144.
- 10. Barlehner E, Benhidjeb T, Anders S, et al. Laparoscopic resection for rectal cancer: outcomes in 194 patients and review of the literature [Ｊ]. Surg Endosc, 2005; 19(6):757.
- 11. 吴鸿根, 黄顺荣. 腹腔镜结直肠癌切除术 [Ｊ]. 中国微创外科杂志, 2007; 7(6):573.
- 12. 于永扬， 杨烈， 周总光， 等. 腹腔镜全直肠系膜切除保肛术后生活质量评估 [Ｊ]. 中国普外基础与临床杂志， 2007; 14(5):524.
- 13. 刘宏杰， 曾山崎. 超声刀在腹腔镜直肠全系膜切除术中的临床应用 [Ｊ]. 岭南现代临床外科, 2008; 8(1):14.
- 14. 于永扬, 王存, 周总光. 腹腔镜下结直肠癌手术(四) [Ｊ]. 中国普外基础与临床杂志, 2008; 15(7):533.
- 15. 李敏哲， 杜燕夫， 韩进， 等. 腹腔镜直肠癌TME手术的临床应用 [Ｊ]. 结直肠肛门外科, 2006; 12(4):210.
- 16. 于永扬， 王存， 周总光. 腹腔镜下结直肠癌手术(五) [Ｊ]. 中国普外基础与临床杂志, 2008; 15(8):620.
- 17. 王国斌， 牛彦锋， 卢晓明， 等. 腹腔镜辅助下结直肠癌手术的疗效分析 [Ｊ]. 中国普通外科杂志, 2006; 15(8):561.
- 18. 谢昭雄， 许国平， 黄振添， 等. 腹腔镜技术在直肠癌的临床应用(附9例报告) [Ｊ]. 中国普外基础与临床杂志, 2007; 14(5):536.
- 19. 郑民华， 马君俊. 腹腔镜外科在争议中发展 [Ｊ]. 中国普外基础与临床杂志， 2007; 14（5）:503.
- 20. 程龙庆， 丁卫星， 邓建中. 电子肠镜在腹腔镜结直肠切除术中的应用 [Ｊ]. 中国内镜杂志， 2008; 14（4）:407.
