Standardized Laparoscopic Sphincter-preserving Total Mesorectal Excision for Rectal Cancer
| Autor: | Kürşat Rahmi Serin, Mine Gulluoglu, Yalın İşcan, Ethem Nezih Oral, Hasan Karanlik, Oktar Asoglu, Gulcin Yegen, Enver Kunduz, Yersu Kapran, Baris Bakir |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Colon Colorectal cancer Operative Time Rectum Postoperative Complications Colon Sigmoid Colon surgery Humans Medicine Mesentery Laparoscopy Ligation Aged Aged 80 and over Splenic flexure medicine.diagnostic_test Rectal Neoplasms business.industry Sigmoid colon Length of Stay Middle Aged medicine.disease Total mesorectal excision Surgery Dissection Treatment Outcome medicine.anatomical_structure Female Neoplasm Recurrence Local business Colon Transverse Follow-Up Studies |
| Zdroj: | Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 24:145-152 |
| ISSN: | 1530-4515 |
| Popis: | Purpose This study was designed to evaluate the impact of a standardized laparoscopic total mesorectal excision (TME) on the long-term oncologic outcome of unselected patients with rectal cancer (RC). Methods Unselected consecutive patients with histologically proven RC underwent a standardized laparoscopic TME with medial to lateral approach encompassing 9 sequential steps: (1) ligation of inferior mesenteric vessels, (2) mobilization of the left colon and sigmoid colon (medial to lateral), (3) posterior dissection of the rectum, (4) lateral mobilization of the sigmoid, left colon, and splenic flexure, (5) left and right side dissection of the rectum, (6) anterior dissection of the rectum, (7) transection of the rectum, (8) delivery of the specimen, and (9) colorectal anastomosis. Results From 2005 to June 2012, laparoscopic sphincter-preserving TME was attempted in 217 patients with a 6.5% conversion rate. There were 91 women and 126 men, aged 58.3 years (range, 22 to 84 y), with body mass index of 26.10 (range, 20 to 45), operative time was 150.4 minutes (range, 60 to 330 min), and 24.7 (range, 4 to 98) lymph nodes were harvested. Length of stay was 7.56 days (range, 3 to 32 d). Complication rate was 17.05%. The mean follow-up time of all patients was 36.12 months (range, 1 to 89 mo). Local recurrence rate was 3.6% and distant recurrence rate was 8.7%. The 5-year disease-free survival rates were 81.5%. Conclusions A standardized laparoscopic sphincter-preserving TME resulted in a favorable short-term outcome in unselected patients with RC. |
| Databáze: | OpenAIRE |
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