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.

中文翻译：

---

腹部手术切除术中泌尿生殖器diaphragm肌的直接解剖

目的比较两种会阴清扫术在腹部手术切除的直肠癌中的临床效果。方法2007年6月至2011年6月在河南省肿瘤医院对总共126例接受Miles手术的直肠癌患者进行了随机对照试验。他们分为两组。一组（A组）直接切除了泌尿生殖器diaphragm肌，而另一组（B组）接受了传统的手术方法。比较两组的会阴手术时间，直肠或肿瘤破裂，尿道损伤以及会阴出血的术后发生率。结果A组会阴手术的时间较短（（16±5）分钟对（23±5）分钟，P = 0.032）。并且差异在统计学上是显着的。然而，两组的直肠或肿瘤破裂，尿道损伤和会阴出血的发生率是相同的（1 vs 5，2 vs 5，0 vs 1，1 vs 3，所有P> 0.05）。结论与常规手术方法相比，直接切除泌尿生殖器diaphragm膜在腹部手术切除中具有更多的临床优势。