Direct dissection of urogenital diaphragm in abdominoperineal resection

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 urogential 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 pest-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 urogential diaphragm offers more clinical advantages over the traditional operative method in abdominoperineal resection. Key words: Rectal neoplasms ; Perineum; Colorectal surgery; Urogenital diaphragm