Unit:
ΠΜΣ Ελάχιστα Επεμβατική Χειρουργική, Ρομποτική Χειρουργική & ΤηλεχειρουργικήLibrary of the School of Health Sciences
Author:
Σπυριδάκης Ιωάννης
Supervisors info:
Γκρινιάτσος Ιωάννης, Τσιγκρής Χρήστος, Νικητέας Νικόλαος
Original Title:
Laparoscopic low anterior resection for rectal-rectalsigmoid cancer: Retrospective study and literature review
Summary:
Introduction: Laparoscopic colectomy is considered to be the treatment of
choice in colon afflictions. However, it is still debatable whether
laparoscopic excision of rectal and rectal-sigmoid cancer offers comparable
results compared to an open approach.
Objective: To establish whether results from the application of this approach
during the period 2005-2010 in our clinic are comparable to an open approach.
Materials: Forty five patients with rectal/ rectalsigmoid cancer were operated
on laparoscopically in our clinic from 2005 to 2010.
Methods: A retrospective documentation of intra-operative and post-operative
complications from case files with rectal/rectalsigmoid cancer patients, who
underwent laparoscopic excision. Additionally, a documentation of the pathology
reports was performed and an evaluation of the oncological adequacy of the
excisions.
Results: Forty five patients with rectal and rectalsigmoid cancer and one
patient with anal cancer were operated on laparoscopically in our clinic during
the last five years. Twenty six were male and nineteen female. Their age ranged
from 45 to 82 years, with a mean age of 64.6 years. In forty of the cases a
lower anterior resection was performed and in 5 an abdominoperineal resection.
In two patients there was a conversion to open colectomy. A prophylactic
ileostomy was performed in eight patients. In the aforementioned cases,
patients had a tumor located less than 10 cm from the anus. The procedure was
combined with a right hemicolectomy in one case and with a hepatectomy in
another case. The mean post-operative hospitalization period was 8.7 days (4-37
days). Major complications were noted in one patient, who presented a leak from
the anastomosis and hemorrhage and therefore was subjected to a new resection
and anastomosis and eventually to an abdominoperineal resection due to a new
leak. The average number of excised lymphnodes was 17 (7-42) and the distance
from the upper excision border was in full compliance with surgical and
pathological guidelines.
Conclusions: From the analysis of data, it becomes clear that a laparoscopic
approach to rectal and rectalsigmoid cancer has comparable results to an open
approach as far as oncological adequacy and post-operative complications are
concerned and patients reap the benefits of minimally invasive surgery.
Keywords:
laparoscopic colectomy, rectal cancer, clinical trials, meta-analysis, retrospective study
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