The Value of Laparoscopic Total Mesorectal Excision and Circumferential Resection Margin in the Treatment of Distal Rectal Cancer: Single Center Experience
Journal of Surgery
Volume 4, Issue 5, October 2016, Pages: 114-121
Received: Aug. 22, 2016; Accepted: Aug. 30, 2016; Published: Sep. 18, 2016
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Authors
Samy Abbas Elbaz, General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospital, Mansoura University, Mansoura City, Egypt
Waleed Hassan Omar, General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospital, Mansoura University, Mansoura City, Egypt
Hosam Ghazy Elbanna, General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospital, Mansoura University, Mansoura City, Egypt
Mohamed Youssef, General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospital, Mansoura University, Mansoura City, Egypt
Sameh Hany Emile, General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospital, Mansoura University, Mansoura City, Egypt
Mohamed Farid, General Surgery Department, Colorectal Surgery Unit, Mansoura University Hospital, Mansoura University, Mansoura City, Egypt
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Abstract
Total mesorectal excision (TME) has emerged as a method for complete cure of rectal cancer with promising results. The present study aimed to evaluate the technical feasibility and the clinical and oncological outcomes of laparoscopic TME with abdominoperineal resection (APR) for distal rectal carcinoma. Twenty patients with distal rectal carcinoma were treated with laparoscopic APR and TME in the period of January 2012 to March 2015. Patients’ demographics, clinical symptoms, operation time, complications, pathological characteristics of the rectal tumor, and the local and distant recurrence of the tumor were recorded and analyzed. The study included 11 (55%) female and 9 (45%) male of a mean age of 46.9 ± 10.8 years. The mean distance of the tumor from the anal verge was 3.35 ± 0.9 cm. The mean operation time was 182 ± 7 minutes. Adenocarcinoma accounted for 55% of cases, whereas mucinous adenocarcinoma was detected in 40% of patients, and signet ring carcinoma in 5%. The mean circumferential resection margin (CRM) was 4.6 ±3.5 mm. The mean duration of hospital stay was 9.21± 6.9 days. Perioperative complications were recorded in seven patients (35%). Five (25%) cases were converted to open surgery. The median follow-up duration was 18 months. Local recurrence was diagnosed in two (10%) cases. Laparoscopic TME is a technically feasible procedure, yet requires adequate training and sufficient knowledge of the anatomy of the pelvis. Although all patients underwent APR and 90% of them received neoadjuvant treatment; the local recurrence was still higher than other studies which can be attributed to the pathologic characters and the stage of the tumors.
Keywords
Laparoscopic, TME, Abdominoperineal Resection, Rectal Cancer, CRM, Outcome
To cite this article
Samy Abbas Elbaz, Waleed Hassan Omar, Hosam Ghazy Elbanna, Mohamed Youssef, Sameh Hany Emile, Mohamed Farid, The Value of Laparoscopic Total Mesorectal Excision and Circumferential Resection Margin in the Treatment of Distal Rectal Cancer: Single Center Experience, Journal of Surgery. Vol. 4, No. 5, 2016, pp. 114-121. doi: 10.11648/j.js.20160405.15
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Copyright © 2016 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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