Laparoscopic Total Mesorectal Excision with Enbloc Resection of Seminal Vesicle for Locally Advanced Rectal Adenocarcinoma

Pai, Vishwas D.; Bhandare, Manish; Saklani, Avanish

doi:10.1089/lap.2015.0445

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…Our institute is a high volume referral center for colorectal cancer [33] and we do perform e-TME, b-TME, and multivisceral resection for locally advanced and locally recurrent rectal cancer [34][35][36] . We standardized our technique of laparoscopic pelvic exenteration [37,38] .…”

Section: Ogura Et Almentioning

confidence: 99%

Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

Kumar¹,

Kammar²,

Saklani³

2018

MIS

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Minimal invasive surgery (MIS) is an accepted modality of treatment for rectal cancer. The indications for MIS have gradually been extended to locally advanced and locally recurrent rectal cancer as a result of technological advances in instrumentation, advances in surgical techniques, increased surgeon experience, and high volume center. However, safety and feasibility of laparoscopic surgery and robotic surgery in beyond total mesorectal excision (b-TME) and extended TME (e-TME) are not well established. This review summarizes the current evidence for MIS approach for b-TME/extended resections in rectal cancer. A systematic search was carried out in PubMed. Studies available in English related to MIS approach in b-TME/e-TME in rectal cancers were identified and evaluated. This review concludes MIS is feasible with good perioperative outcomes in b-TME/e-TME in carefully selected patients. Laparoscopic surgery has considerable learning curve and should be performed by experienced surgical teams. Robotic surgery is feasible and beneficial in complex resection in pelvis. However, evidence for long-term oncological outcomes of MIS in b-TME/e-TME is low and needs to be studied further by randomized controlled trial once enough numbers are possible in institutes with high volume rate.

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Section: Ogura Et Almentioning

confidence: 99%

Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

Kumar¹,

Kammar²,

Saklani³

2018

MIS

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“…14 We came across three reports of en-bloc resection of the seminal vesicles, [15][16][17] one of which is our own initial experience of two patients. 17 Though rare, this clinical situation offers the unique opportunity of performing an R0 resection with en-bloc resection of one or both seminal vesicles, preserving both the prostate and bladder and more importantly avoiding the morbidity of a cysto-urethral anastomosis. Isolated involvement of the seminal vesicles is rarely seen as the Denonvillier's fascia is usually resistant to tumour invasion.…”

Section: Discussionmentioning

confidence: 99%

“…Keating et al report on eight such cases in 500 consecutive rectal resections at their tertiary centre. 14 We came across three reports of en-bloc resection of the seminal vesicles, [15][16][17] one of which is our own initial experience of two patients. 17 Though rare, this clinical situation offers the unique opportunity of performing an R0 resection with en-bloc resection of one or both seminal vesicles, preserving both the prostate and bladder and more importantly avoiding the morbidity of a cysto-urethral anastomosis.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive, ‘en‐bloc’ seminal vesicle excision for locally advanced rectal adenocarcinoma: surgical technique and short‐term outcomes

Desouza

Kazi

Bankar

et al. 2022

ANZ Journal of Surgery

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Background: Isolated seminal vesicle invasion is a rare occurrence in patients with locally advanced rectal cancers. This study describes the surgical technique and the perioperative outcomes of minimally invasive 'en-bloc' seminal vesicle excision, preserving the bladder and the prostate. Methods: A retrospective review of 23 consecutive patients who underwent minimally invasive, en-bloc resection of seminal vesicles for locally advanced, non-metastatic rectal adenocarcinoma between May 2016 and November 2021. Perioperative outcomes and short-term oncological outcomes were defined. Results: Eighteen patients underwent a laparoscopic procedure while five received a robotic resection. All patients received preoperative radiation with or without consolidation chemotherapy. The median age was 42 years (range 20-64 years) and the median hospital stay was 8 days (range 3-19 days), respectively. Serious complications (Clavien-Dindo ≥ IIIb) were seen in six patients (26.1%). Two patients (8.7%) had an involved circumferential resection margin. At a median follow up of 19 months (range 2-52 months), four patients developed recurrences. The 2-year overall and disease-free survival was 84.4% and 73.6%, respectively. Conclusion: Minimally invasive, en-bloc resection of one or both seminal vesicles for locally advanced rectal adenocarcinoma, is feasible in a select group of patients with acceptable morbidity and short-term outcomes.

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“…All the operations followed TME principles. Detailed surgical procedures have been described in previous published studies 9,10 (Fig. 1).…”

Section: Surgical Techniquesmentioning

confidence: 99%

Laparoscopic total mesorectal excision combined with en‐bloc seminal vesicle and prostate resection for rectal cancer after chemoradiotherapy

Zhang

Deng

et al. 2020

ANZ Journal of Surgery

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Background: This study aimed to explore the surgical outcomes of laparoscopic total mesorectal excision (TME) combined with en-bloc seminal vesicle resection (SVR) and partial prostate resection (PPR) for locally advanced rectal cancer (LARC) after chemoradiotherapy (CRT). Methods: Patients receiving TME combined with en-bloc SVR and PPR for LARC after CRT from 2014 to 2019 were enrolled retrospectively. Patients' characteristics and surgical outcomes were collected and analysed. Results: A total of six male patients were enrolled in this study. Among them, four patients proved to be T4b stage including three Denonvilliers fascia invasion and one seminal vesicle invasion. R0 resection was achieved in all patients. With a median follow-up time of 24 months, no local recurrence was observed. Conclusion: It is safe and feasible to perform laparoscopic TME combined with en-bloc SVR and PPR in selected LARC patients after neoadjuvant CRT. It can provide a safe circumferential resection margin and R0 resection. More studies are warranted to improve the diagnostic accuracy for T4b stage after CRT and avoid unnecessary extended resection.

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Laparoscopic Total Mesorectal Excision with Enbloc Resection of Seminal Vesicle for Locally Advanced Rectal Adenocarcinoma

Cited by 5 publications

References 12 publications

Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

Minimal invasive approach for beyond total mesorectal excision/extended resections in rectal cancer

Minimally invasive, ‘en‐bloc’ seminal vesicle excision for locally advanced rectal adenocarcinoma: surgical technique and short‐term outcomes

Laparoscopic total mesorectal excision combined with en‐bloc seminal vesicle and prostate resection for rectal cancer after chemoradiotherapy

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