title: [Efficacy observation of paralleled clipping of rectal ligament in resection of rectal cancer in obese male patients].
abstract: OBJECTIVE
  To investigate the approach and efficacy of dealing the rectal ligament in resection of rectal cancer in obese male patients.
  
  
  METHODS
  A total of 92 patients (BMI>25 kg/m(2)) undergoing resection of rectal cancer from December 2008 to December 2010 in Henan Tumor hospital were assigned into 2 groups according to the surgical technique, the modified group (paralleled clipping of rectal ligament, 48 patients) and traditional group (44 patients). Operative time, intra-operational bleeding, rectal ulceration, ureteral injury, mesorectal integrity, and positive rate of lateral margin of pelvic wall were compared between two groups.
  
  
  RESULTS
  The operative time was (66.9±99.8) min in modified group, which was significantly shorter than that in traditional group [(125.4±12.2) min, P=0.000]. Intra-operative bleeding was (160.3±27.2) ml in modified group and (150.5±28.5) ml in traditional group (P=0.093). Rectal ulceration rated were 0 and 18.2% (8/44), mesorectal disintegrity rates were 6.2% and 22.7%, pelvic infection rates were 2.1% (1/48) and 20.4 (9/44) in modified and traditional groups respectively, whose differences were all significant (all P<0.05). No ureteral injury and positive margin were found in both two groups.
  
  
  CONCLUSIONS
  The approach of paralleled clipping of rectal ligament around the rectum meets the principle of TME, which is simple, safe and effective.
authors.affiliation: Department of General Surgery, Affiliated Tumor Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Gang-cheng
authors.initials: GC
authors.lastname: Wang
authors.forename: Guang-sen
authors.initials: GS
authors.lastname: Han
authors.forename: Ying-kun
authors.initials: YK
authors.lastname: Ren
authors.forename: Yong-chao
authors.initials: YC
authors.lastname: Xu
authors.forename: Jian-guo
authors.initials: JG
authors.lastname: Xie
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008022:Ligaments / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D012004:Rectal Neoplasms / Q000150:complications / Q000601:surgery*; D012007:Rectum / Q000601:surgery