title: [Technical improvements and results of individual cylindrical abdominoperineal resection for locally advanced low rectal cancer].
abstract: OBJECTIVE
  To evaluate the safety and efficacy of individual cylindrical abdominoperineal resection (CAPR) for locally advanced low rectal cancer.
  
  
  METHODS
  From June 2011 to February 2012, 11 patients with locally advanced low rectal cancer underwent individual CAPR. There were 7 male and 4 female patients, aged from 32 to 74 years with a median of 64 years. Forty-seven patients underwent classic CAPR from January 2008 to February 2012. Preoperative and postoperative parameters such as clinical information of patients, tissue morphometry and complications were compared.
  
  
  RESULTS
  In the individual surgical group, 6 patients were treated with one side levator ani muscle totally or partially reserved, 3 patients with sacrococcyx reserved, and 2 patients with dissection close to the anterior rectal wall. Compared with classical surgery, the individual surgical specimens of horizontal section area ((2197 ± 501) mm(2)) and intrinsic muscle layer outer area ((1722 ± 414) mm(2)) were small, but the difference was not statistically significant (P = 0.150 and 0.167). The operative time, intraoperative blood loss, circumferential resection margin, total cross sectional tissue area, cross sectional tissue area outside the muscularis propria and bowel perforation rate between the two groups were not significantly different. Individual CAPR showed less incidence of chronic perineal pain (2/11, χ(2) = 6.116, P = 0.013) and sexual dysfunction (2/9, χ(2) = 4.412, P = 0.036) compared with classic CAPR.
  
  
  CONCLUSIONS
  Individual CAPR has the potential to reduce the risk of chronic perineal pain and sexual dysfunction without influencing the radical effect when compare with classic CAPR for the treatment of low rectal cancer.
authors.affiliation: Department of General Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
authors.forename: Jia-gang
authors.initials: JG
authors.lastname: Han
authors.forename: Zhen-jun
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Guang-hui
authors.initials: GH
authors.lastname: Wei
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Gao
authors.forename: Yong
authors.initials: Y
authors.lastname: Yang
authors.forename: Bing-qiang
authors.initials: BQ
authors.lastname: Yi
authors.forename: Hua-chong
authors.initials: HC
authors.lastname: Ma
authors.forename: Bo
authors.initials: B
authors.lastname: Zhao
authors.forename: Bao-cheng
authors.initials: BC
authors.lastname: Zhao
authors.forename: Hao
authors.initials: H
authors.lastname: Qu
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010502:Perineum / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome