Clinical Outcome of Laparoscopic Intersphincteric Resection Combined with Transanal Rectal Dissection for T3 Low Rectal Cancer in Patients with a Narrow Pelvis

Purpose. The purpose of this study was to analyze the safety and feasibility of laparoscopic intersphincteric resection (ISR) combined with transanal rectal dissection (TARD) for T3 low rectal cancer in a narrow pelvis.Methods. We studied 20 patients with a narrow pelvis of median body mass index 25.3 (16.9–31.2). Median observation period was 23.6 months (range 12.2–56.7).Results. Partial, subtotal, and total ISR was performed in 15, 1, and 4 patients, respectively. Median duration of TARD was 83 min (range 43–135). There were no major complications perioperatively or postoperatively. Surgical margins were histologically free of tumor cells in all patients, and there was no local recurrence. Excluding urgency, frequency of bowel movements, and incontinence status improved gradually after stoma closure.Conclusion. Laparoscopic ISR combined with TARD is technically feasible for selective T3 low rectal cancer in patients with a narrow pelvis.

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Laparoscopic intersphincteric resection with hand-sewn coloanal anastomosis in the treatment of low rectal cancer: 10-year experience

European Surgery ◽

10.1007/s10353-021-00694-z ◽

2021 ◽

Author(s):

Lam Viet Trung ◽

Tran Vu Duc ◽

Nguyen Vo Vinh Loc ◽

Tran Phung Dung Tien ◽

Nguyen Lam Vuong

Keyword(s):

Rectal Cancer ◽

Coloanal Anastomosis ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Laparoscopic Intersphincteric Resection

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Risk factors for local recurrence and long term survival after minimally invasive intersphincteric resection for very low rectal cancer: Multivariate analysis in 161 patients

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2021.03.246 ◽

2021 ◽

Author(s):

G.N. Piozzi ◽

H. Park ◽

T.H. Lee ◽

J.S. Kim ◽

H.B. Choi ◽

...

Keyword(s):

Risk Factors ◽

Rectal Cancer ◽

Multivariate Analysis ◽

Local Recurrence ◽

Minimally Invasive ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Term Survival ◽

Very Low Rectal Cancer

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Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2021.752009 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jie Zhang ◽

Xingshun Qi ◽

Fangfang Yi ◽

Rongrong Cao ◽

Guangrong Gao ◽

...

Keyword(s):

Rectal Cancer ◽

Clinical Efficacy ◽

Da Vinci ◽

Meta Analysis ◽

Outcome Data ◽

Intersphincteric Resection ◽

Low Rectal Cancer ◽

Cochrane Library ◽

Alternative Choice ◽

Laparoscopic Intersphincteric Resection

Background and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.Results: Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], P = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], P = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], P < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], P = 0.02).Conclusions: The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.

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