Comparative Analysis Of The Clinical Effect Of Miles Technique And The Anus Preserving Operation For Low Rectal Cancer

Objective: in the actual treatment, patients with rectal cancer often in hospital when they had in the progress of the disease, although for rectal cancer patients,treatment methods are varied, but the surgical treatment is still the most effective treatment. In previous clinical in patients with rectal cancer commonly used for the Miles operation, the surgical defect is the greatest need of patients with permanent colostomy, once the permanent colostomy, will not only affect the patient’s physiology,also will affect the patient’s psychology. With the constant accumulation of experience in clinical surgery for rectal cancer, anal preserving operation in recent years have begun to be developed further in clinic, in order to observe the clinical effect of Miles technique and the anus preserving for rectal cancer, the author carried out the experiment, observation and contrast analysis of clinical effect of Miles technique and the anus preserving operation for low rectal cancer.Methods: retrospective analysis of 2008-2011 years in Liaoning province people’s Hospital for 168 patients with rectal cancer surgical treatment of patients, according to the different surgical procedures will be divided into the Miles group(88 cases) and anal sphincter preserving surgery group(80 cases), compared two groups of patients was observed after QOL score, the local recurrence rate, distant metastasis rate and different Dukes stages 1 and 3 years survival rate and distance in patients with different tumor from the anal margin of two groups of patients were 1 years and 3 years survival rate; the occurrence rate of two groups of patients with early complications.Results: The sphincter preserving surgery postoperative survival of patients with tumor mass(QOL) score was 72.7 + 3.1 in Miles group were significantly higher thanthe 54.5 + 3.1(P < 0.05); postoperative local recurrence rate of anus preserving operation group was 5%, Miles group 6.82%, two groups compared with P > 0.05;surgery the rate of distant metastasis after anus preserving operation group was 12.50%,Miles group 15.91%, two groups compared with P > 0.05; early postoperative complication rate of Miles group was 5%, the sphincter preserving surgery group11.36%. The two group compared to P > 0.05; sphincter preserving surgery group, 1years survival rate was 92.50%, 3 year survival rate was 72.50%, Miles group 1 year survival rate was 92.05%, 3 year survival rate was 75% in patients with different distance of the tumor from the anal verge in two groups of 1 year and 3 year survival rates of the two groups. Compared with P > 0.05. Anal sphincter preserving surgery group, Dukes A, 1 year survival rate, 3 year survival rates were: 31.25%, 25%; Dukes B,the 1 year survival rate, 3 year survival rates were: 27.50%, 25%; Dukes C, the 1 year survival rate, 3 year survival rates were: 23.75%, 18.75%; DukesD the 1 year survival rate, 3 year survival rates were: 10%, 3.75%. Miles group in different Dukes stages 1,3year survival rates for Dukes A: the 1 year survival rate, 3 year survival rates were:26.14%, 22.73%; Dukes B, the 1 year survival rate, 3 year survival rates were: 40.91%,32.95%; Dukes, 1 year survival rate of C, the 3 year survival rates were: 18.18%,15.19%; DukesD, 1 year survival rate, 3 year survival rates were: 6.82%, 3.41%. Two groups of patients in different Dukes stages in 1, 3 year survival rate had no significant difference. Tumor anus preserving operation group of the distance from the anal verge to the 1 year survival rate of 5cm-6cm is: 32.50%, 3 years survival rate: 25%; distance of the tumor from the anal verge to the 1 year survival rate of 6cm-7cm is: 60%, 3 years survival rate: 47.50%; Miles group of tumor from the anal verge distance of the 1 year survival rate of 5cm-6cm is: 38.64%, 3 years survival rate: 31.82%; distance of the tumor from the anal verge to the 1 year survival rate of 6cm-7cm is: 53.41%, 3 year survival rate is: 43.81%, compared two groups of patients, no significant difference(P >0.05). Comparison of patients with different distance of the tumor from the anal verge of two groups of patients within 2 years in tumor recurrence, in anus preserving operation of the distance from the anal verge is 5cm-6cm 2 years recurrence rate:13.33%; distance of the tumor from the anal verge is 6cm-7cm 2 years recurrence rate:12%. Tumor Miles surgery group, of the distance from the anal verge is 5cm-6cm 2years recurrence rate: 16.13%; distance of the tumor from the anal verge is 6cm-7cm 2years recurrence rate: 9.09%. Patients with different distance of the tumor from the anal verge of two groups of patients in the recurrence within 2 years there was no difference in statistics.Conclusion: the clinical effect of Miles technique and near the anus preserving for rectal cancer, two groups of patients with distant metastasis rate in postoperative, early postoperative complications, postoperative 1,3 years survival rate without significant difference, but the sphincter preserving surgery treatment can effectively guarantee the quality of life of patients after operation.