First Feasibility Study and Short-term Outcomes of Laparoscopic-Assisted Anterior Resection in Colorectal Cancer in Malaysia

Abstract

Purpose: The purpose of this study was to demonstrate the feasibility and safety of laparoscopic-assisted anterior resection (LAAR) for colorectal cancer in a local Asian population.Methods: This is a retrospective review of all patients with colorectal cancer operated from November 2017 to October 2018. Main variables of interest were demography, type and surgery, length of stay (LOS), and the involvement of proximal and distal doughnut. Postoperative complications were analysed using chi-square or Fisher exact and Mann-Whitney tests.Results: There were 23 patients with a mean age of 62.5 ± 12.2 years. The mean time from diagnosis to surgery was 97.1 ± 154.84 days. There were 12 patients in the LAAR group and 11 in the open anterior resection (OAR) group. Duration of surgery was shorter in OAR (129.58 ± 51.38 minutes) compared to LAAR (147.91 ± 39.37 minutes). Mean LOS was shorter in the LAAR group with 5±1.5 days compared to the OAR group of 7.42 ± 4.25 days. However, there was no significant P-value for both duration of surgery (P = 0.322) or LOS (P = 0.87). A total of 3 complications were recorded after OAR and 2 after LAAR. Both groups had clear proximal and distal margins with 16 (12–18.5) harvested lymph nodes in LAAR and 18 (16–22) in OAR, which were equal (P = 0.155).Conclusion: This study reports a shorter LOS in the minimally invasive group of 2 days with similar oncologic resection outcomes. This shows that LAAR is feasible in Malaysia and has potential outcome benefits.

Perforated caecal carcinoma within a strangulated inguinal hernia

“…Colorectal cancer is the second commonest cancer in Malaysia, with an overall incidence rate of 21.32 cases per 100 000. It occurs more among males than females (24.16 and 18.14 per 100 000, respectively), with Chinese ethnicity with the highest incidence rate 1 . Similarly, inguinal hernia is a common condition in Malaysia with a peak incidence of 0.18% in the local population 2 .…”

“…It occurs more among males than females (24.16 and 18.14 per 100 000, respectively), with Chinese ethnicity with the highest incidence rate. 1 Similarly, inguinal hernia is a common condition in Malaysia with a peak incidence of 0.18% in the local population. 2 However, the presentation of colon cancer identified within an inguinal hernia with concomitant strangulation and perforation is uncommon.…”

Low Anterior Resection Syndrome: Pathophysiology, Risk Factors, and Current Management

“…In addition to stage 0-I CRC, locally advanced stage II-III CRC is also resected en bloc together with surrounding organs or structures; therefore, surgical treatment is the most important treatment for CRC [3]. Multidisciplinary approaches to the treatment of rectal cancer and improved surgical techniques, including laparoscopic [4] and robotic total mesorectal excision [5], have improved the rate of local recurrence and postoperative complications [6] following rectal resection. Owing to the development of surgical techniques and multimodal treatment in rectal cancer, sphincter preservation surgery is preferred over abdominoperineal resection which requires a permanent colostomy [7].…”