Evaluating the result of sphincteric-preserving surgery (Parks procedure) for low rectal cancer

Trinh Le Huy , Ngo Van Ty

Nội dung chính của bài viết

Tóm tắt

Sphincter-preserving surgery for low rectal cancer improved the quality of life while maintaining the oncologic outcomes. A retrospective, descriptive study was conducted with 45 patients who underwent sphincter-preserving surgery for low rectal cancer at the National Cancer Hospital and Hanoi Medical University Hospital between January 2016 and April 2020. The mean age was 55.6 years old. Male: female ratio = 0.7:1. Nearly all patients presented with hematochezia (95.6%). 75.6% of the tumors are located within 4-6 cm from the anal verge. The anastomotic leak rate was 4.4%. All patients had a normal postoperative urinary function. The sexual dysfunction rate was low (15.8%) and reversible. None had erectile or ejaculation dysfunction. 97.8% satisfied with sphincter function after one year. Tumors located > 4 cm and the anastomosis sites located > 2 cm from the anal verge were good prognostic factors for the recovery of sphincter function (p < 0.05). The Parks procedure had optimistic postoperative outcomes with a low complication rate, minimal sexual dysfunction, and good sphincter function in long-term follow-up.

Chi tiết bài viết

Tài liệu tham khảo

1. Freddie Bray, Jacques Ferlay, Isabelle Soerjomataram. Cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.
2. Plummer JM, Leake PA, Albert MR. Recent advances in the management of rectal cancer: No surgery, minimal surgery or minimally invasive surgery. World J Gastrointest Surg. 2017;9(6):139-148.
3. Perry WB, Connaughton JC. Abdominoperineal resection: how is it done and what are the results?. Clin Colon Rectal Surg. 2007;20(3):213-220.
4. Timmcke, Alan E. The ASCRS textbook of colon and rectal surgery. 2007;7(1):48-48.
5. Van Hieu N. Surgery in colorectal cancer. Medicine Publisher. 2010;269-283.
6. Quoc Dat P. Evaluating the treatment result of sphincter preserving surgery in low rectal cancer. Thesis 2011. Hanoi Medical University.
7. Cam Phuong P. Evaluating the efficacy of neoadjuvant concurrent chemoradiotherpay in locally advanced rectal cancer. Thesis 2012. Hanoi Medical University
8. Hong KS, Moon N, Chung SS, Lee RA, Kim KH. Oncologic outcomes in rectal cancer with close distal resection margins: a retrospective analysis. Ann Surg Treat Res. 2015;89(1):23-29.
9. Rahman MS, Khair MA, Khanam F. Sphincter saving surgery is the standard procedure for treatment of low rectal cancer. Mymensingh Med J. 2013;22(2):281-288.
10. Rahman MS, Khair MA, Khanam F, et al. Sphincter saving surgery is the standard procedure for treatment of low rectal cancer. Mymensingh Med J. 2013;22(2):281-288.
11. Duc Trong N. Evaluating the treatment results of total mesoractal excision in mid and low rectal cancer. Thesis 2011. Hanoi Medical University.
12. Pocard M, Zinzindohoue F, Haab F, Caplin S. A prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer. Surgery. 2002;131(4):368-372.
13. Hoang Anh P, Ba Son N, Hong Tuan N. Evualuating the bladder and sexual function after low anterior resection with autonomic nerve preservation. Journal of Military Pharmaco-Medicine. 2005;30(5):108-115.
14. Ito M, Saito N, Sugito M, Kobayashi A. Analysis of clinical factors associated with anal function after intersphincteric resection for very low rectal cancer. Dis Colon Rectum. 2009;52(1):64-70.
15. Koyama M, Murata A, Sakamoto Y. Long-term clinical and functional results of intersphincteric resection for lower rectal cancer. Ann Surg Oncol. 2014;21(3):422-428.