Laparoscopic low anterior resection for early rectal cancer

Tech Coloproctol. 2011 Oct:15 Suppl 1:S75-7. doi: 10.1007/s10151-011-0737-x.

Abstract

Introduction: Early rectal cancer (ERC) is adenocarcinoma that has invaded into, but not extended beyond, the submucosa. Endoscopic or minimal access surgical procedures, such as laparoscopic resection, have emerged as a useful tool in the surgical treatment of such diseases. The aim of this study is to present and analyze the feasibility, the short- and long-term results of laparoscopic colorectal surgery (LCS) in patients with ERC.

Patients and methods: Between 2002 and 4/2011, a total of 164 patients with colorectal cancer underwent laparoscopic surgery (LS). Of these, 7 patients (4.2%) had ERC and underwent laparoscopic anterior resection (LAR). The median follow-up was 41 months.

Results: The mean operative time was 2.5 h. None of the laparoscopic procedures was converted to open surgery. Liquids and solid food were started on median postoperative days 1 and 3, respectively. The median length of postoperative stay was 5 days. Postoperative complications occurred in 2 patients (28.5%), including wound infection in one patient (14.2%) and atelectasis in one patient (14.2%). None of the patients required an urgent re-operation. There was no mortality related to LS.

Conclusions: LS for ERC can be used as a strategy sited between endoscopic mucosal resection and open anterior resection with beneficial long- and short-term results. It appears as a technically and oncologically safe procedure when performed by surgeons with sufficient experience in laparoscopic techniques.

MeSH terms

  • Adenocarcinoma / surgery*
  • Aged
  • Follow-Up Studies
  • Humans
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Middle Aged
  • Pulmonary Atelectasis / etiology
  • Rectal Neoplasms / surgery*
  • Surgical Wound Infection / etiology
  • Time Factors
  • Treatment Outcome