[Clinical application of artificial anal reconstruction after laparoscopic abdominoperineal resection in low rectal cancer patients].
OBJECTIVE
To assess the outcome and quality of life artificial anal reconstruction after laparoscopic abdominoperineal resection(APR) in low rectal cancer patients.


METHODS
Clinical data of 60 cases with low rectal cancer undergoing APR in our department from January 2010 to January 2013 were retrospectively analyzed. Sixty patients were divided into 2 groups according to anal reconstruction procedure, inclding 32 patients of abdominal colostomy as colostomy group and 28 patients of in-situ artificial anal reconstruction as anal reconstruction group. After a median follow-up of 1 year, the quality of life was assessed by Fetal Incontinence Quality of Life Scale(FIQL scale) and Cleveland Clinic Florida Fecal Incontinence Scores(CCS-FIS scale). In addition, the outcome and complications were compared between the two groups.


RESULTS
Compared with the colostomy group, the anal reconstruction group presented longer operation time [(204.8 ± 18.8) min vs. (173.3 ± 23.5) min, P<0.01], later passage time [(45.1 ± 9.3) h vs. (27.7 ± 9.4) h, P<0.01], and higher incidence of mucosal edema(42.9% vs. 18.8%, P<0.05). There were no significant differences in average hospital stay and other complication morbidities(all P>0.05). After follow-up, the embarrassment scale in anal reconstruction group was better compared to colostomy group(3.1 vs. 2.2, P<0.01). However, there were no significant differences in the lifestyle, coping and depression scales between the two groups (all P>0.05). Twenty(71.4%) patients in anal reconstruction group had satisfactory continence 1 year after operation.


CONCLUSIONS
In-situ artificial anal reconstruction after laparoscopic abdominoperineal resection can preserve fecal function in low rectal cancer patients and improve the quality of life after APR operation.
Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China. guan-wx@163.com.
Meng
M
Wang
Hao
H
Wang
Wenxian
W
Guan
D000005:Abdomen; D001003:Anal Canal; D003125:Colostomy; D013505:Digestive System Surgical Procedures; D005242:Fecal Incontinence; D006801:Humans; D010535:Laparoscopy; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D012004:Rectal Neoplasms; D012189:Retrospective Studies