标题：Application of modified primary closure of the pelvic floor in laparoscopic extralevator abdominal perineal excision for low rectal cancer
作者：Yan-Lei Wang;Xiang Zhang;Jia-Jia Mao;Wen-Qiang Zhang;Hao Dong;Fan-Pei Zhang;Shuo-Hui Dong;Wen-Jie Zhang;Yong Dai
作者机构：[Yan-Lei Wang;Xiang Zhang;Jia-Jia Mao;Wen-Qiang Zhang;Hao Dong;Fan-Pei Zhang;Shuo-Hui Dong;Wen-Jie Zhang;Yong Dai]Department of Colorectal and Anal Su 更多
通讯作者地址：[Dai, Y]Shandong Univ, Qilu Hosp, Dept Colorectal & Anal Surg, 107 West Wenhua Rd, Jinan 250012, Shandong, Peoples R China.
关键词：Extralevator abdominoperineal excision; Rectal cancer; Pelvic floor;; Laparoscopy
摘要：AIM To introduce a novel,modified primary closure technique of laparoscopic extralevator abdominal perineal excision(LELAPE) for low rectal cancer.METHODS We retrospectively analyzed data from 76 patients with rectal cancer who underwent LELAPE from March 2013 to May 2016.Patients were classified into the modified primary closure group(32 patients) and the biological mesh closure group(44 patients).The total operating time,reconstruction time,postoperative stay duration,total cost,postoperative complications and tumor recur-rence were compared.RESULTS All surgery was successfully performed.The pelvic reconstruction time was 14.6 ± 3.7 min for the modified primary closure group,which was significantly longer than that of the biological mesh closure group(7.2 ± 1.9 min,P < 0.001).The total operating time was not different between the two groups(236 ± 20 min vs 248 ± 43 min,P = 0.143).The postoperative hospital stay duration was 8.1 ± 1.9 d,and the total cost was 9297 ± 1260 USD for the modified primary closure group.Notably,both of these categories were significantly lower in this group than those of the biological mesh closure group(P = 0.001 and P = 0.003,respectively).There were no differences observed between groups when comparing other perioperative data,long-term complications or oncological outcomes.CONCLUSION The modified primary closure method for reconstruction of the pelvic floor in LELAPE for low rectal cancer is technically feasible,safe and cost-effective.