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Therapeutic Results of Abdominoperineal Resection in the Prone Jackknife Position for T3–4 Low Rectal Cancers

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Objective

To evaluate the therapeutic results of abdominoperineal resections in the prone jackknife position for T3–4 low rectal cancers.

Methods

From January 2002 to January 2011, 536 patients with T3–T4 low rectal cancer underwent abdominoperineal resection. Two hundred forty-three were treated in the Lloyd-Davies position and 293 in the prone jackknife position. Clinicopathological data and survival of the two groups were analyzed retrospectively.

Results

Abdominoperineal resections in the prone jackknife position group were associated with significantly less blood loss (124 ± 50.68 vs 210.67 ± 83.32 ml, P < 0.001) and shorter operation times (3.10 ± 1.08 vs 3.82 ± 1.43 h, p = 0.010) than those in Lloyd-Davies position group. The total local recurrence rate is 8.4 % (45/536). The local recurrence rate in the prone jackknife position group was significantly lower than in the Lloyd-Davies position group (5.5 vs 11.9 %, P < 0.001). By multivariate regression analysis, depth of tumor invasion (P = 0.032), CRM (P < 0.001), and position (P = 0.015) were found to be independent risk factors for local recurrence. Multivariate Cox regression survival analysis, lymph node metastasis, and CRM (P < 0.001) were proven to be the major independent prognostic factors for T3–T4 low rectal cancer patients.

Conclusions

Abdominoperineal resection in the prone jackknife position for T3–T4 low rectal cancers is feasible and has a lower local recurrence.

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Conflict of interest

The authors indicate no potential conflicts of interest.

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Authors and Affiliations

  1. Department of General Surgery, The First Affiliated Hospital, Dalian Medical University, No. 222 Zhongshan Road, Dalian, 116011, China

    Xiang Hu, Liang Cao, Jian Zhang, Pin Liang & Ge Liu

Authors
  1. Xiang Hu
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  2. Liang Cao
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  3. Jian Zhang
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  4. Pin Liang
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  5. Ge Liu
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Corresponding author

Correspondence to Xiang Hu.

Additional information

Liang Cao and Xiang Hu contributed equally to this study.

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Hu, X., Cao, L., Zhang, J. et al. Therapeutic Results of Abdominoperineal Resection in the Prone Jackknife Position for T3–4 Low Rectal Cancers. J Gastrointest Surg 19, 551–557 (2015). https://doi.org/10.1007/s11605-014-2683-1

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  • DOI: https://doi.org/10.1007/s11605-014-2683-1

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