[Direct dissection of urogenital diaphragm in abdominoperineal resection].

ABSTRACT

OBJECTIVE: To compare the clinical outcomes of two operative approaches of perineal dissection in rectal carcinoma undergoing abdominoperineal resection. METHODS: A randomized controlled trial was conducted in a total of 126 patients with rectal cancer undergoing the Miles operation from June 2007 to June 2011 at Henan Provincial Cancer Hospital. They were divided into 2 groups. One group (Group A) underwent a direct dissection of urogenital diaphragm while another group (Group B) received the traditional operative method. And the duration of perineal surgery, rupture of rectum or tumor, urethral injury and the post-operative rate of perineal hemorrhage were compared between 2 groups. RESULTS: Group A had a shorter duration of perineal surgery ((16 ± 5) min vs (23 ± 5) min, P = 0.032). And the differences were significant statistically. However the rupture of rectum or tumor, urethral injury and the post-operative rate of perineal hemorrhage were equivalent for two groups (1 vs 5, 2 vs 5, 0 vs 1, 1 vs 3, all P > 0.05). CONCLUSION: A direct dissection of urogenital diaphragm offers more clinical advantages over the traditional operative method in abdominoperineal resection.