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Journal of Gastrointestinal Surgery

, Volume 14, Issue 4, pp 645–650 | Cite as

Safety and Feasibility of Laparoscopic Intersphincteric Resection for Very Low Rectal Cancer

  • Yoshiya Fujimoto
  • Takashi Akiyoshi
  • Hiroya Kuroyanagi
  • Tsuyoshi Konishi
  • Masashi Ueno
  • Masatoshi Oya
  • Toshiharu Yamaguchi
Original Article

Abstract

Background

Laparoscopic surgery has been reported to be one of the approaches for total mesorectal excision (TME) in rectal cancer surgery. Intersphincteric resection (ISR) has been reported as a promising method for sphincter-preserving operation in selected patients with very low rectal cancer.

Methods

From July 2005 to December 2008, 35 patients with very low rectal cancer underwent laparoscopic TME with ISR. The results were compared retrospectively with those of previous open TME with ISR.

Results

Conversion to open surgery was necessary in one (3%) patient. The median operation time was 293 min and median estimated blood loss was 40 ml. The pelvic plexus was completely preserved in 32 patients. There was no mortality. Postoperative complications occurred in three (9%) patients. The median length of postoperative hospital stay was 17 days. Macroscopic complete mesorectal excision was achieved in all cases. Complete resection (R0) was achieved in 34 patients. Clinical lymph node stage, operation time, and blood loss were significantly different between the laparoscopic group and open group, but the differences of other factors were not statistically significant.

Conclusions

Laparoscopic TME with ISR is technically feasible and a safe alternative to laparotomy with favorable short-term postoperative outcomes.

Keywords

Laparoscopic surgery Total mesorectal excision Intersphincteric resection Low rectal cancer 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2010

Authors and Affiliations

  • Yoshiya Fujimoto
    • 1
  • Takashi Akiyoshi
    • 1
  • Hiroya Kuroyanagi
    • 1
  • Tsuyoshi Konishi
    • 1
  • Masashi Ueno
    • 1
  • Masatoshi Oya
    • 1
  • Toshiharu Yamaguchi
    • 1
  1. 1.Department of Gastroenterological SurgeryCancer Institute HospitalKoto-kuJapan

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