Short-Term Outcomes of Laparoscopic Intersphincteric Resection for Lower Rectal Cancer and Comparison with Open Approach

Yamamoto, Seiichiro; Fujita, Shin; Aoki, Takayuki; Inada, Ryo; Takawa, Masashi; Moriya, Yoshihiro

doi:10.1159/000332007

Cited by 28 publications

(23 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Thus, we had had completed the study curve and obtained extensive experience for a lower conversion rate between the two surgical techniques. Moreover, the incidence of perioperative complication rates in the LRR group was similar to that in the ORR group as previously reported [27] , findings parallel to our results, with no statistical significance between the LRR (19.3%) and ORR (24.1%) groups.…”

supporting

confidence: 92%

Clinical comparison of laparoscopyvsopen surgery in a radical operation for rectal cancer: A retrospective case-control study

Huang

Shen

Zhang

et al. 2015

WJG

View full text Add to dashboard Cite

AIM:To assess the diverse immediate and longterm clinical outcomes, a retrospective comparison between laparoscopic and conventional operation was performed. METHODS:A total number of 916 clinical cases, from January 2006 to December 2013 in our hospital, were analyzed which covered 492 patients underwent the laparoscopy in radical resection (LRR) and 424 cases in open radical resection (ORR). A retrospective analysis was proceeded by comparing the general information, surgery performance, pathologic data, postoperative recovery and complications as well as long-term survival to investigate the diversity of immediate and long-term clinical outcomes of laparoscopic radical operation. Retrospective Study ORIGINAL ARTICLERESULTS: There were no statistically significance differences between gender, age, height, weight, body mass index (BMI), tumor loci, tumor node metastasis stages, cell differentiation degree or American Society of Anesthesiologists scores of the patients (P > 0.05). In contrast to the ORR group, the LRR group experienced less operating time (P < 0.001), a lower blood loss (P < 0.001), and had a 2.44% probability of conversion to open surgery. Postoperative bowel function recovered more quickly, analgesic usage and the average hospital stay (P < 0.001) were reduced after LRR. Lymph node dissection during LRR appeared to be slightly more than in ORR (P = 0.338). There were no obvious differences in the lengths and margins (P = 0.182). And the occurrence rate in the two groups was similar (P = 0.081). Overall survival rate of ORR and LRR for 1, 3 and 5 years were 94.0% and 93.6% (P = 0.534), 78.1% and 80.9% (P = 0.284) and 75.2% and 77.0% (P = 0.416), respectively. CONCLUSION:Laparoscopy as a radical operation for rectal cancer was safe, produced better immediate outcomes. Long-term survival of laparoscopy revealed that it was similar to the open operation.

show abstract

supporting

confidence: 92%

Clinical comparison of laparoscopyvsopen surgery in a radical operation for rectal cancer: A retrospective case-control study

Huang

Shen

Zhang

et al. 2015

WJG

View full text Add to dashboard Cite

show abstract

“…In the present study, the estimated blood loss was good compared to that in some previous reports, suggesting that the NS technique does not always increase the risk of tissue damage when grasping target organs . Additionally, NS is safe for ISR and APR when performing precise total mesenteric excision.…”

Section: Discussionsupporting

confidence: 65%

“…Additionally, NS is safe for ISR and APR when performing precise total mesenteric excision. In this case series, the mean operative time for NS for ISR or APR, including LPLND cases, was also good compared to that in previous reports …”

Section: Discussionsupporting

confidence: 64%

Needlescopic surgery for very low rectal cancer with no abdominal skin incision

Fukuoka

Fukunaga

Minami

et al. 2019

Asian J Endoscop Surgery

View full text Add to dashboard Cite

Introduction Needlescopic surgery (NS) is a minimally invasive operation beyond traditional laparoscopic surgery. This study aimed to describe NS for intersphincteric resection (ISR) and abdominoperineal resection (APR) for low rectal cancer without a small abdominal skin incision for extracting the specimen and to evaluate the safety and feasibility of the operation. Methods From January 2011 to April 2016, 36 patients underwent NS for either ISR or APR. By definition, NS for ISR or APR at our institution uses three 3‐mm ports and two 5‐mm ports at the umbilicus and in the right lower quadrant. The specimen was extracted through the anus or the perineal wound. The feasibility of this operation was determined based on short‐term outcomes and pathological findings. Results No patients required conversion to open surgery. The mean operation time was 299 minutes, and the mean estimated blood loss was 30 mL. Postoperative complications higher than Clavien–Dindo grade III occurred in 2.8% of patients (n = 1). The median number of harvested lymph nodes was 16 (range, 0‐30), and in no case was there a positive circumferential resection margin. Conclusions Needlescopic surgery for ISR or APR is technically safe and feasible for low rectal cancer based on the short‐term outcomes and the oncological quality, particularly when compared to conventional laparoscopic surgery as described in previous reports.

show abstract

“…Our previous studies have described the associated complications (20–23). Recently, Dindo proposed a novel system for classifying surgical complications; the Clavien-Dindo classification (24).…”

Section: Discussionmentioning

confidence: 99%

Safety and feasibility of laparoscopic intersphincteric resection for a lower rectal tumor

et al. 2017

View full text Add to dashboard Cite

The aim of the present study was to evaluate the short-term surgical outcomes of laparoscopic intersphincteric resection (ISR) for a lower rectal tumor in comparison with a case-control series of patients undergoing open ISR. Quality of life factors and anal function were also evaluated. Between July 2008 and April 2013, 103 patients with lower rectal cancer underwent laparoscopic surgery at the Surgical Oncology Department of Gifu University School of Medicine. A total of 25 patients with lower rectal cancer underwent ISR, and 19/25 patients who underwent laparoscopic ISR were compared with the control group of 6 patients who underwent open ISR. The technical feasibility and safety of ISR, and the short- and long-term outcomes following laparoscopic ISR were evaluated. Additional data associated with fecal incontinence conditions of the postoperative patients were evaluated using the Modified Fecal Incontinence Quality of Life scale. There was no recorded perioperative mortality, three complications were observed to occur in three patients and the morbidity rate was 15.8%. The postoperative complications detected included bleeding in one patient and ileus in two patients of the laparoscopic ISR group. The rate of severe complications of grade ≥3a was 15.8% and that of grade ≥3b was 5.3%. In the matched case-control study, blood loss was significantly lower in the laparoscopic ISR group. The median postoperative hospital stay was 14.1 days in the laparoscopic ISR group, which was significantly shorter compared with in the open ISR group (18.7 days). Cancer recurrence was detected in one (5%) patient in a single inguinal lymph node. No significant differences between the ISR and ultra-low anterior resection (ULAR) groups were observed in the maximum resting and maximum squeeze pressures; the outcomes for anal function and fecal incontinence were the same for ISR and ULAR. Thus, laparoscopic ISR for lower rectal cancer may provide a benefit in the early postoperative period without increasing morbidity or mortality.

show abstract

Short-Term Outcomes of Laparoscopic Intersphincteric Resection for Lower Rectal Cancer and Comparison with Open Approach

Cited by 28 publications

References 40 publications

Clinical comparison of laparoscopyvsopen surgery in a radical operation for rectal cancer: A retrospective case-control study

Clinical comparison of laparoscopyvsopen surgery in a radical operation for rectal cancer: A retrospective case-control study

Needlescopic surgery for very low rectal cancer with no abdominal skin incision

Safety and feasibility of laparoscopic intersphincteric resection for a lower rectal tumor

Contact Info

Product

Resources

About