Surgery Of PPH Anal Dilator-assisted Low Laparoscopic And Sphincter Preservation

Purpose: To explore the methods, advantages, safety and application value in the surgery ofPPH anal dilator-assisted low laparoscopic and sphincter preservation.Methods: Review and analyse 36 patient examples who were performed with the surgery of PPHanal dilator-assisted low laparoscopic and sphincter preservation from July, 2009 to March, 2011.Results: The operative time was 110 ~ 240min, the median operative time was 125min andblood loss was 15 ~ 100ml, median 25ml, exhaust time of 28 ~ 144h, the exhaust time of 36h,postoperative inlet time 3d 8d food time.get out of bed time 1 ~ 4d, for the time 2d, postoperativehospital stay was 23 days, in time of 9d.Pathological examination: The average tumor diameter(3.5±1) cm, the mean tumor resection margin (3.1±1) cm, the average specimen length (22±2cm), the average number of lymph nodes (12±4). Cancer cells were not seen at both upper andlower cutting edges of bowel.Three patients were suspected abdominal infection in postoperativetime and recovered uneventfully after conservative treatment. Four cases of anastomotic leakagewere cured due to stoma with transverse colon.Six patients were lack of controlling stools andthe controlling of dried defecate and exhaust were far more fair. Follow-up in three months.defecate ability had been normal. Patients were followed up for 12 to 32 months, medianfollow-up for 22 months. Three caes had the problems of local recurrence, no findings ofmetastasis in the abdominal wall puncture hole, no distant metastasis and no death reports.Conclusion: The surgery of PPH anal dilator-assisted low laparoscopic and sphincterpreservation can achieve the same radical purpose compared with laparotomy. And it has someadvantages of less trauma and quick recovery of gastrointestinal function, less postoperativecomplications. Not only guarantee a good cure, but also improve patients’ quality of life. It’sworthy of clinical application.