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AIM The incision in rectal cancer operation is adopted commonly in the left mid-lower abdomen. But thereare some defects for the incision, which is close to the artificial colotomy, readily be contaminated by feces,difficult to treat the lesions in hepatic and cholecystic area at the same time and in the weakened area ofabdominal wall. So, we employed the abdominal right lower paramedian incision to solve these problems.METHODS The abdominal right lower paramedian incision is from publc tubercle upward to 3 cm- 4 cmabove navel. The incision should be extended upward if individual need of performing hepatic and cholecysticoperation, or placing catheter or pump in hepatic artery or portal vein for chemotherapy at the same time.RESULTS One hundred and eighty three cases with rectal cancer were adopted this incision in differentoperation procedure, and out of them 41 patients were taken different operation on hepatic and cholecysticlesions and place a catheter or pump to hepatic artery or portal vein. Operators feel that the incision dose nothinder exploring and operating in all of the patients.CONCLUSION The right lower paramedian incision of abdomen is far away from the artificial colotomy,and it can reduce the feces contamination, lower down the rate of incision hernia and paramedian hernia orfistula. Furthermore, it is easy to treat the complicated hepatic and cholecystic lesion. So, authors suggestthat this incision is useful for the operation of rectal cancer, and it is worth to populize in clinical practice.
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AIM To study the biopathologic characteristics of the transitional mucosa (TM) adjacent to rectalcarcinoma and the resecting length of bowel.METHODS Immunohistochemical and mucin histochemical methods were used in 81 cases to observe theexpression of PCNA and the changing regulations of TM adjacent to rectal carcinoma.RESULTS The PCNA expression rate was the highest in cancer and gradually decreased in atypicaldysplasia, TM and normal mucosa (P<0.01). The range of TM adjacent to the mucinous adenocarcinomawas more extensive than that to the papilla adenocarcinoma and the tubular adenocarcinoma (P< 0.01 ). Therange of TM adjacent to the rectal carcinoma in Dukes C stage was more extensive than that in stage A, B(P<0.01, P<0.05).CONCLUSION The TM of rectal carcinoma possesses certain potential of malignancy. The range of TMadjacent to rectal carcinoma is closely related to the pathological type and advancement of rectal carcinoma.