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Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma

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Abstract

Background

Laparoscopic-assisted resection for colorectal lesions is feasible, but most reported series are heterogeneous and noncomparative. The aim of this study was to investigate whether laparoscopic-assisted resection was better than open abdominoperineal resection for low rectal adenocarcinoma.

Methods

Twenty-five (study group) of 59 consecutive patients who were considered suitable were selected for laparoscopic-assisted abdominoperineal resection based on the availability of informed consent, laparoscopic instruments, and experienced surgeons. The results in these patients were compared with the other 34 patients operated on by the open method (control group).

Results

The median follow-up times for the study and control groups were 30.1 and 28.3 months, respectively. The operation time was significantly longer (t-test, p<0.001), while operative blood loss (Mann-Whitney U test, p=0.02), postoperative analgesic requirement (Mann-Whitney U test, p=0.02), time to resume normal diet (Mann-Whitney U test, p=0.04), and total hospital stay (Mann-Whitney U test, p=0.02) were significantly less in the study than in the control group. The oncological clearance, complication rate, disease-free interval, and survival were comparable in the two groups.

Conclusions

Laparoscopic-assisted abdominoperineal resection allowed earlier postoperative recovery, with equal oncological clearance, morbidity, mortality, disease-free interval, and survival.

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References

  1. Ballantyne GH (1995) Laparoscopic-assisted colorectal surgery: review of results in 752 patients. Gastroenterologist 3: 75–89

    PubMed  CAS  Google Scholar 

  2. Barkun JS, Barkun AN, Sampalis JS, Fried G, Taylor B, Wexler MJ, Goresky CA, Meakins JL (1992) Randomized controlled trial of laparoscopic versus mini-cholecystectomy. Lancet 340: 1116–1119

    Article  PubMed  CAS  Google Scholar 

  3. Clarke DN, Jones PF, Needham CD (1980) Outcome of colorectal carcinoma: seven-year study of a population. Br Med J 1: 431–435

    Article  Google Scholar 

  4. Dean PA, Beart RW Jr, Nelson H, Elftmann TD, Schlinkert RT (1994) Laparoscopic-assisted segmental colectomy: early Mayo Clinic experience. Mayo Clin Proc 69:834–84.

    PubMed  CAS  Google Scholar 

  5. Fodera M, Pello MJ, Atabek U, Spence RK, Alexander JB, Camishion RC (1995) Trocar site tumour recurrence after laparoscopic-assisted colectomy. J Laparoendosc Surg 5: 259–262

    PubMed  CAS  Google Scholar 

  6. Halpern NB, Cox CB, Aldrete JS (1989) Abdominoperineal resection for rectal carcinoma: perioperative risk factors. South Med J 82: 1492–1496

    PubMed  CAS  Google Scholar 

  7. Heald RJ, Ryall RDH (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1: 1479–1482

    Article  PubMed  CAS  Google Scholar 

  8. Irvin TT, Goligher JC (1975) A controlled clinical trial of three different methods of perineal wound management following excision of the rectum. Br J Surg 62: 287–291

    Article  PubMed  CAS  Google Scholar 

  9. Jacquet P, Averbach AM, Jacquet N (1995) Abdominal wall metastasis and peritoneal carcinomatosis after laparoscopic-assisted colectomy for colon cancer. Eur J Surg Oncol 21: 568–570

    Article  PubMed  CAS  Google Scholar 

  10. Kazemier G, Bonjer HJ, Berends FJ, Lange JF (1995) Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 82: 1141–1142

    Article  PubMed  CAS  Google Scholar 

  11. Kwok SPY, Lau WY, Carey PD, Kelly SB, Leung KL, Li AKC (1996) Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. Ann Surg 223: 170–176

    Article  PubMed  CAS  Google Scholar 

  12. Monson JRT, Darzi A, Carey PD, Guillou PJ (1992) Prospective evaluation of laparoscopic-assisted colectomy in an unselected group of patients. Lancet 340: 831–833

    Article  PubMed  CAS  Google Scholar 

  13. Petrelli NJ, Nagel S, Rodriguez-Bigas M, Piedmonte M, Herrera L (1993) Morbidity and mortality following abdominoperineal resection for rectal adenocarcinoma. Am Surg 59: 400–404

    PubMed  CAS  Google Scholar 

  14. Phillips EH, Franklin M, Carroll BJ, Fallas MJ, Ramos R, Rosenthal D (1992) Laparoscopic colectomy. Ann Surg 216: 703–707

    Article  PubMed  CAS  Google Scholar 

  15. Pollard CW, Nivatvongs S, Rojanasakul A, Ilstrup DM (1994) Carcinoma of rectum. Profiles of intraoperative and early postoperative complications. Dis Colon Rectum 37: 866–874

    Article  PubMed  CAS  Google Scholar 

  16. Rosen L, Veidenheimer MC, Coller JA, Corman ML (1982) Mortality, morbidity, and patterns of recurrence after abdominoperineal resection for cancer of the rectum. Dis Colon Rectum 25: 202–208

    Article  PubMed  CAS  Google Scholar 

  17. Rothenberger DA, Wong WD (1992) Abdominoperineal resection for adenocarcinoma of the low rectum. World J Surg 16: 478–485

    Article  PubMed  CAS  Google Scholar 

  18. Tate JJT, Kwok S, Dawson JW, Lau WY, Li AKC (1993) Prospective comparison of laparoscopic and conventional anterior resection. Br J Surg 80: 1396–1398

    Article  PubMed  CAS  Google Scholar 

  19. Turunen MJ, Peltokallio P (1983) Surgical results in 657 patients with colorectal cancer. Dis Colon Rectum 26: 606–612

    Article  PubMed  CAS  Google Scholar 

  20. Wakefield SE, Baigrie RJ, Macleod AJ, Berry AR (1996) Colorectal cancer surgery in a district general hospital. J R Coll Surg Edinb 41: 374–378

    PubMed  CAS  Google Scholar 

  21. Zucker KA, Pitcher DE, Martin DT, Ford RS (1994) Laparoscopic-assisted colon resection. Surg Endosc 8: 12–18

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong

    K. L. Leung, W. Y. Lau, W. C. S. Meng, C. C. Chung & P. B. S. Lai

  2. Department of Surgery, United Christian Hospital, Hong Kong

    S. P. Y. Kwok & K. H. Kwong

Authors
  1. K. L. Leung
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  2. S. P. Y. Kwok
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  3. W. Y. Lau
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  4. W. C. S. Meng
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  5. C. C. Chung
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  6. P. B. S. Lai
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  7. K. H. Kwong
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Leung, K.L., Kwok, S.P.Y., Lau, W.Y. et al. Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma. Surg Endosc 14, 67–70 (2000). https://doi.org/10.1007/s004649900014

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  • DOI: https://doi.org/10.1007/s004649900014

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