Anastomotic Leakage After Low Anterior Resection for Rectal Cancer Is Different Between Minimally Invasive Surgery and Open Surgery

Kim, Chang Woo; Baek, Se Jin; Hur, Hyuk; Min, Byung Soh; Baik, Seung Hyuk; Kim, Nam Kyu

doi:10.1097/sla.0000000000001157

Cited by 85 publications

(58 citation statements)

References 20 publications

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“…A previous study investigating SILS reported that the average number of staples for total mesorectal excision was 4 and an average of 6 was used for partial mesorectal excision . Furthermore, an increased number of stapler applications for distal rectum transection has been established as risk factor for anastomotic leakage . In the case of rectal cancer in our series, we made an additional suprapubic port for stapler access and safe rectal transection, which was not pure single‐incision robotic surgery.…”

Section: Discussionmentioning

confidence: 98%

Initial clinical experience of single‐incision robotic colorectal surgery with da Vinci SP platform

Noh

Han

et al. 2020

Robotics Computer Surgery

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Background: The da Vinci Surgical System (Intuitive Surgical, Sunnyvale, CA) was introduced to overcome the limitations of single-incision laparoscopic surgery, which is challenging due to its restrictions regarding triangulation and retraction. The purpose of this article is to describe the initial experience with single-incision surgery using the da Vinvci Single-Port Platform (dVSP). Methods:The medical records of patients with colorectal disease, who underwent single-incision robotic surgery using the dVSP, were retrospectively reviewed.Results: Five patients with appendiceal and colorectal cancer, and two with diverticulitis were enrolled. All procedures were completed using a pure single-incision approach, with an exception for low anterior resection. There were two minor complications. For patients with colorectal cancer, the number of retrieved lymph nodes and status of the resection margin were acceptable, and cosmetic results were satisfactory. Conclusion:The dVSP is a novel surgical platform that can be used as an alternative surgical modality for colorectal surgery. K E Y W O R D S colorectal surgery, da Vinci SP, robotic surgery, single-incision

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Section: Discussionmentioning

confidence: 98%

Initial clinical experience of single‐incision robotic colorectal surgery with da Vinci SP platform

Noh

Han

et al. 2020

Robotics Computer Surgery

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“…According to recent studies, male gender, preoperative chemo-radiotherapy, lower tumor location as well as increased number of stapler application for distal rectal transection have been established risk factors for AL. [11–13] Although there seems to be an overall consensus that AL is related to poor prognosis, the oncologic consequence in patients with AL is uncertain. There are several contradictory studies with respect to long-term and cancer-specific survival of patients with AL.…”

Section: Introductionmentioning

confidence: 99%

“…[11] This reflects that variable physiologic and biochemical processes after different surgical approaches may influence the clinical manifestation of AL. In this context, we hypothesize that the oncologic outcomes after AL may differ in relation to various clinical, biochemical, and pathological factors.…”

Section: Introductionmentioning

confidence: 99%

Impact of anastomotic leakage on long-term oncologic outcome and its related factors in rectal cancer

et al. 2016

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Anastomotic leakage (AL) is a well-known cause of morbidity after low anterior resection (LAR) for rectal cancer, but its impact on oncologic outcome is not well understood. The aim of this study is to investigate the impact of AL on long-term oncologic outcome and to identify factors associated with AL that may affect prognosis after LAR for rectal cancer.A retrospective analysis of patients who underwent curative resection for rectal cancer without diverting stoma was performed. To investigate AL related factors that may be associated with oncologic outcome, Clavien-Dindo grades, prognostic nutritional indices (PNI) and inflammatory indices were included.One hundred and one patients out of a total of 1258 patients developed postoperative AL, giving an AL rate of 8.0%. Patients with AL showed poorer disease-free survival (DFS), than patients without AL (hazard ratio [HR] = 1.6; 95% confidence intervals [CI]: 1.1–2.5; P = 0.01). In patients who developed AL, age over 60 (HR = 2.2; 95% CI: 1.1–4.7; P = 0.033), advanced pathologic stage (HR = 2.4; 95% CI: 1.4–4.0; P = 0.001), suppressed neutrophil-proportion (≤80%) (HR = 2.6; 95% CI: 1.2–5.8; P = 0.019) and PNI <36 (HR = 3.5; 95% CI: 1.2–9.6; P = 0.018) were associated with poorer DFS.AL was associated with poorer DFS. In patients with AL, a suppressed neutrophil-proportion and decreased PNI below 36 were associated with tumor recurrence.

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“…Anastomotic leakage, with the incidents ranging from 2.7% to 28%, remains potentially fatal surgical complication both short‐term operative and long‐term oncologic outcomes after LAR, which because of possible risk factors including age, ASA, BMI, tumor location, hemoglobin, blood loss, and operation time . As we all know, radiation can decrease oxygen delivery to the tissues and postpone healing.…”

Section: Resultsmentioning

confidence: 99%

Safety and efficacy of intraoperative iodine‐125 seed implantation brachytherapy for rectal cancer patients: A retrospective clinical research

Luo

Liu

et al. 2016

J of Gastro and Hepatol

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Anastomotic Leakage After Low Anterior Resection for Rectal Cancer Is Different Between Minimally Invasive Surgery and Open Surgery

Abstract: The clinical manifestations of and risk factors for AL were different between MIS and OS. AL after MIS may be more influenced by factors related to technical difficulties. Close attention should be given to patients undergoing surgery with risk factors for AL.

Cited by 85 publications

References 20 publications

Initial clinical experience of single‐incision robotic colorectal surgery with da Vinci SP platform

Initial clinical experience of single‐incision robotic colorectal surgery with da Vinci SP platform

Impact of anastomotic leakage on long-term oncologic outcome and its related factors in rectal cancer

Safety and efficacy of intraoperative iodine‐125 seed implantation brachytherapy for rectal cancer patients: A retrospective clinical research

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