Functional results of robotic total intersphincteric resection with hand-sewn coloanal anastomosis
| Autor: | C. Garberoglio, Manuela Valvo, D. Simo, M. Guerra-Cogorno, Fabrizio Luca, E. Blesa-Sierra, Roberto Biffi |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
medicine.medical_specialty Colorectal cancer medicine.medical_treatment Anal Canal 03 medical and health sciences 0302 clinical medicine Postoperative Complications Rectal Adenocarcinoma Medicine Humans Robotic surgery Coloanal anastomosis Laparoscopy Aged medicine.diagnostic_test business.industry Rectal Neoplasms Anastomosis Surgical Colostomy General Medicine Robotics Anal canal Middle Aged medicine.disease Colorectal surgery Surgery medicine.anatomical_structure Treatment Outcome Oncology 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business |
| Zdroj: | European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology. 42(6) |
| ISSN: | 1532-2157 |
| Popis: | Background In recent decades there has been an increasing trend toward sphincter-preserving procedures for the treatment of low rectal cancer. Robotic surgery is considered to be particularly beneficial when operating in the deep pelvis, where laparoscopy presents technical limitations. The aim of this study was to prospectively evaluate the functional outcomes in patients affected by rectal cancer after robotic total intersphincteric resection (ISR) with hand-sewn coloanal anastomosis. Methods and procedures From March 2008 to October 2012, 23 consecutive patients affected by distal rectal adenocarcinoma underwent robotic ISR. Operative, clinical, pathological and functional data regarding continence or presence of a low anterior resection syndrome (LARS) were prospectively collected in a database. Results Twenty-three consecutive patients were included in the study: 8 men and 15 women. The mean age was 60.2 years (range 28–73). Eighteen (78.3%) had neoadjuvant radiochemotherapy. Conversion rate was nil. The mean operative time was 296.01 min and the mean postoperative hospital stay was 7.43 ± 1.73 days. According to Kirwan's incontinence score, good fecal continence was shown in 85.7% of patients (Grade 1 and 2) and none required a colostomy (Grade 4). Concerning LARS score, the results were as follows: 57.1% patients had no LARS; 19% minor LARS and 23.8% major LARS. Conclusions Robotic total ISR for low rectal cancer is an acceptable alternative to traditional procedures. Extensive discussion with the patient about the risk of poor functional outcomes or LARS syndrome is mandatory when considering an ISR for treatment of low rectal cancer. |
| Databáze: | OpenAIRE |
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