Laparoscopic total mesorectal excision combined with intersphincteric resection for ultra-low rectal cancer. Zhonghua Wei Chang Wai Ke Za Zhi 14: 440-442. Chinese
ABSTRACT To evaluate clinical outcomes after laparoscopic total mesorectal excision (TME) combined with intersphincteric resection (ISR) for ultra-low rectal tumors.
Clinical data of 36 patients with ultra-low rectal tumor undergoing laparoscopic TME combined with ISR were analyzed retrospectively.
The median distance from the inferior margin of the tumor to the anal verge was 3.4 (2.0-5.0) cm. There were 33 cases of well/moderately differentiated adenocarcinoma and 3 rectal malignant villous adenoma. There were 16 patients with stage I disease, 15 with stage II A, 3 with stage III A, and 1 with III B. Postoperatively, one patient developed stenosis at the end ileostomy and 3 anastomotic leakage. After a median follow-up of 16(4-49) months, one patient developed local recurrence at the anastomosis and one case died of liver metastasis. In the 19 patients who had a minimum follow-up of one year, the bowel movements frequency ranged from 1-4 times per day, and these patients were able to withhold defecation for more than 5 minutes.
Laparoscopic TME combined with ISR can achieve oncologic clearance, sphincter preservation, and minimal invasiveness for ultra-lower rectal cancer. However, patients selection should be cautious.
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ABSTRACT: Since its introduction into China in 2001, laparoscopic techniques have been extensively used for the surgical management of colorectal cancer during the last two decades in China. Like all the pioneers of the technique, Chinese gastrointestinal surgeons claim that laparoscopic surgery for colorectal cancer led to faster recovery, shorter hospital stay and more rapid return to daily activities respect to open surgery while offering the same functional and oncological results. There has been booming interest in laparoscopic surgery for colorectal cancer since 2006 in China. The last decade has witnessed national growth in the application of laparoscopic surgery for colorectal cancer and yielded a significant amount of scientific data to support its clinical merits and advantages. However, few prospective randomized controlled trials have investigated the benefits of laparoscopic surgery for colorectal cancer in China. In this article, we make an overview of the current data and state of the art of laparoscopic surgery for colorectal cancer in China.International Journal of Clinical and Experimental Medicine 01/2014; 7(12):4635-45. · 1.42 Impact Factor