Laparoscopy-assisted transvaginal resection of sigmoid cancer
To investigate the feasibility and safety of laparoscopy-assisted transvaginal resection of sigmoid cancer.
From 2009 to 2011 we performed 21 laparoscopy-assisted transvaginal resections of sigmoid cancers.
The resected tumours were T1(6), T2(7) and T3(8). The median number of resected lymphnodes was 15. Median operative time was 150 minutes and no conversion to open technique was necessary. A total of eighteen patients tolerated a liquid diet 24 hours after surgery. The average VAS pain score (0=no pain, 10=unbearable pain) was 1.8 after 24 hours and 1.1 after 48 hours. One patient experienced a postoperative ileus, two patients had vaginal spotting with serous flow and three patients suffered urinary tract infections. One patient developed a hernia at the umbilical trocar site that was operated on. None of the sexually active patients reported any differences in sexual activity pre-op and post-op on a postoperative quetionnaire. After a median of 25 (10–41) months of follow-up, all patients are alive and well, with no evidence of recurrent disease.
Laparoscopy-assisted transvaginal resection of sigmoid cancer is feasible and safe in a selected group of patients.
- SourceAvailable from: Marcello Picchio[Show abstract] [Hide abstract]
ABSTRACT: Intracorporeal anastomosis associated to trans-vaginal specimen extraction decreases the extent of colon mobilisation and the number and size of abdominal incisions, improving the benefits of minimally invasive surgery in female patients. The aim of this study was to evaluate the safety and effectiveness of this procedure for colorectal cancer. Between 2009 and 2013, 13 female patients underwent laparoscopic colon and rectal resection for colorectal cancer with intracorporeal anastomosis and trans-vaginal specimen extraction: 2 right colectomies, 1 transverse colon resection, 4 left colectomies and 6 anterior resections were performed. A MEDLINE search of publications on the presented procedure for colon neoplasms was carried out. There were no intraoperative complications and no conversions. Postoperative visual analogue scale (VAS) score in the pelvis, abdomen and shoulder was moderate. In the postoperative period, we observed two colorectal anastomotic strictures, successfully treated with pneumatic endoscopic dilation. Median length of the specimen was 18.5 cm, with a median tumour size of 5.5 cm in diameter. Median number of retrieved lymph nodes was 12. All circumferential resection margins were negative. During a mean follow-up of 31 months (range, 6-62), there was neither evidence of recurrent disease nor disorders related to the genitourinary system. The aesthetic outcome was considered satisfactory in all patients. Nine studies were identified in the systematic review. Our case series, according to the results of the literature, showed that intracorporeal anastomosis associated to trans-vaginal specimen extraction is feasible and safe in selected female patients.International Journal of Colorectal Disease 03/2015; 30(7). DOI:10.1007/s00384-015-2178-x · 2.45 Impact Factor