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J Minim Access Surg. 2014 Apr;10(2):68-71. doi: 10.4103/0972-9941.129951.

Laparoscopic resection for middle and low rectal cancer.

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1
Department of Surgery, Kosin University College of Medicine, Busan, South Korea.

Abstract

AIMS:

The purpose of this study was to evaluate the technical feasibility, safety and oncological outcomes of laparoscopic resection for middle and low rectal cancers.

MATERIALS AND METHODS:

From January 2004 to December 2011, review of prospectively collected database revealed a series of 97 laparoscopic resections for middle and low rectal cancer within 10 cm from the anal verge. Five patients with multiple primary cancers were excluded. Operation time, intra-operative blood loss, surgical complications, duration of hospital stay, retrieved lymph nodes, tumour, node, metastasis (TNM) stage and recurrence were retrospectively analysed.

RESULTS:

Tumours were located within 5 cm of the anal verge in 28 patients (30.4%) and from 5 cm to 10 cm in 64 patients (69.6%). Abdominoperineal resection was performed in 12 patients (13%), and conversion to open surgery was necessary in four patients (4.3%). The mean operation time was 199.7 min (range 105-450 min) and the mean intra-operative blood loss was 169.9 mL (range 20-800 mL). The mean hospital stay was 11.8 days (range 5-45 days) and a mean of 12.2 lymph nodes were retrieved. The incidence of surgical complications was 11.9%, including anastomosis site leakage in five patients (5.4%). There were no mortalities resulting from laparoscopic surgery. The median follow-up period was 28.4 months (range 7-85 months). Recurrence occurred in eight patients (8.7%).

CONCLUSIONS:

Laparoscopic resection can be applied for middle and low rectal cancers with acceptable surgical and oncological outcomes.

KEYWORDS:

Anastomotic leakage; laparoscopic surgery; rectal cancer; recurrence

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