| Autor: |
Borreca D; Department of General Surgery, Gradenigo Hospital, Turin, Italy, d.borreca@policlinicoumberto1.it., Bona A, Bellomo MP, Borasi A, De Paolis P |
| Jazyk: |
angličtina |
| Zdroj: |
Updates in surgery [Updates Surg] 2015 Sep; Vol. 67 (3), pp. 293-9. Date of Electronic Publication: 2015 Jun 25. |
| DOI: |
10.1007/s13304-015-0306-3 |
| Abstrakt: |
Laparoscopic access in low anterior rectal resection is widely adopted, performing an 'up-to-down' dissection. The aim of this study is to present and analyze the outcomes of a novel surgical 'down-to-up' total mesorectal excision technique that could obviate to the well-known issues of the standard treatment. 18 suitable patients underwent double endolaparoscopic pelvic access (DEPA) 'down-to-up' technique. DEPA TME was completed in all patients, with intact mesorectum. Mean operative time was 365 min (range 280-510 min). The morbidity rate was 22%, including three radiologically detected leakage (grade A) and one pelvic abscess, requiring only a conservative management. Mortality rate at 30 and 90 days was 0%. Resection margins were negative in all patients. A median of 11 nodes (range 5-19) was retrieved per specimen. Mean length of hospital stay was 9 days (range 7-19 days). Patients were followed for an average of 14 months (range 0-42 months), with no recurrence. Despite exiguous patient's sample in this pilot study, transanal endoscopic TME with laparoscopic assistance seems to be feasible and safe, and is a promising alternative to open and laparoscopic TME. However, a conspicuous functional and oncologic long-term evaluation is required, before the widespread adoption could be recommended. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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