scholarly journals Comparison of Survival between Single-Access and Conventional Laparoscopic Surgery in Rectal Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Siripong Sirikurnpiboon
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Local Recurrence ◽  
Demographic Data ◽  
Transanal Total Mesorectal Excision ◽  
Recurrence Rates ◽  
Conventional Laparoscopic Surgery ◽  
Single Access ◽  
Conventional Laparoscopic ◽  
Conversion Rates

Introduction. Innovative laparoscopic surgery for rectal cancer can be classified into 2 types: firstly, new instruments such as robotic surgery and secondly, new technique such as single-access laparoscopic surgery (SALS) and transanal total mesorectal excision (TaTME). Most reports of SALS for rectal cancer have shown pathologic outcomes comparable to those of conventional laparoscopic surgery (CLS); however, SALS is considered to be superior to CLS in terms of lower levels of discomfort and faster recovery rates. This study aimed to compare the survival outcomes of the two approaches. Methods. From 2011 to 2014, 84 cases of adenocarcinoma of the rectum and anal canal were enrolled. The operations were anterior, low anterior, intersphincteric, and abdominoperineal resections. Data collected included postoperative outcomes. The oncological outcomes recorded included 3-year and 5-year survival, local recurrence, and metastasis. Results. SALS was performed on 41 patients, and CLS was utilized in 43 cases. The demographic data of the two groups were similar. Intraoperative volumes of blood loss and conversion rates were similar, but operative time was longer in the SALS group. There were no significant differences in postoperative complications or pathological outcomes. The oncologic results were similar in terms of 3-year survival (100% and 97.7%; p  = 1.00), 5-year survival (78.0% and 86.0%; p  = 0.401), local recurrence rates (19.5% vs 11.6%, p  = 0.376), and metastasis rates (19.5% vs 11.6%; p  = 0.376) for SALS and CLS, respectively. Conclusion. SALS and CLS for rectal and anal cancer had comparable pathological and survival results, but SALS showed some superior benefits in the early postoperative period.

scholarly journals Robotic-assisted surgery for low rectal cancer: Initial experiences from 15 consecutive cases at Cho Ray Hospital

2019 ◽  
Vol 9 (4) ◽  
Author(s):  
Viet Trung Lam ◽  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Range Of Motion ◽  
Laparoscopic Resection ◽  
Low Rectal Cancer ◽  
Safe Procedure ◽  
Conventional Laparoscopic Surgery ◽  
Robotic Assisted ◽  
Conventional Laparoscopic ◽  
Robotic Assisted Surgery

Abstract Introduction: Conventional laparoscopic surgery for low rectal cancer has several challenges regarding the technique issues such as a limited range of motion instruments. With the advantages, Robotic-assisted surgery has resolved this problems compared with the conventional laparoscopic surgery because it’s dexterity could improve the range of motion instruments. To evaluate the short-term and early oncological outcomes of robotic-assisted surgery for low rectal cancer. Material and Methods: Prospective study to describe one consecutive series of robotic-assisted laparoscopic resection for low rectal cancer at Department of Digestive Surgery of Cho Ray hospital. Results: Between October 2017 and June 2018, robotic-assisted laparoscopic resection with total mesorectal excision has performed on 15 consecutive patients with rectal cancer at Cho Ray hospital. The mean age was 50. Male/ female ratio was 2.75/1. The types of procedures performed were: 13 low anterior resections (LAR), 1 intersphincteric resection with coloanal anastomosis, and 1 abdominoperineal resection (APR). The overall mean operation time was 240 minutes. None of the cases was converted to open procedure. Mean harvested lymph nodes were 12. There was no surgical morbidity or mortality. On the postoperative day 1 and 2, mean visual analog scale (VAS) scores were 3.5. Mean postoperative hospital stay was 7.5 days. Conclusion: Robotic-assisted laparoscopic resection for low rectal cancer is a feasible and safe procedure with acceptable oncological results.

scholarly journals Initial Experience with the Safe Implementation of Transanal Total Mesorectal Excision (TaTME) as a Standardized Procedure for Low Rectal Cancer

2020 ◽  
Vol 10 (1) ◽  
pp. 72 ◽  
Author(s):  
Luca Dittrich ◽  
Matthias Biebl ◽  
Rosa Schmuck ◽  
Safak Gül ◽  
Sascha Weiss ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Local Recurrence ◽  
Anal Verge ◽  
Neoadjuvant Chemoradiotherapy ◽  
Laparoscopic Approach ◽  
Oncological Outcome ◽  
Low Rectal Cancer ◽  
Transanal Total Mesorectal Excision ◽  
Mesorectal Excision ◽  
Conversion Rates

Introduction: The laparoscopic approach for TME is proven to be non-inferior in oncological outcome compared to open surgery. Anatomical limitations in the male and obese pelvis with resulting pathological shortcomings and high conversion rates were stimuli for alternative approaches. The transanal approach for TME (TaTME) was introduced to overcome these limitations. The aim of this study was to evaluate the outcomes of TaTME for mid and low rectal cancer at our center. Methods: TaTME is a hybrid procedure of simultaneously laparoscopic and transanal mesorectal excision. A retrospective analysis of all consecutive TaTME procedures performed at our center for mid and low rectal cancer between December 2014 and January 2020 was conducted. Results: A total of 157 patients underwent TaTME, with 72.6% receiving neoadjuvant chemoradiation. Mean tumor height was 6.1 ± 2.3 cm from the anal verge, 72.6% of patients had undergone neoadjuvant chemoradiotherapy, and 34.2% of patients presented with a threatened CRM upon pretherapeutic MRI. Abdominal conversion rate was 5.7% with no conversion for the transanal dissection. Early anastomotic leakage occurred in 7.0% of the patients. Mesorectum specimen was complete in 87.3%, R1 resection rate was 4.5% (involved distal resection margin) and in 7.6%, the CRM was positive. The three-year local recurrence rate of 58 patients with a follow-up ≥ 36 months was 3.4%. Overall survival was 92.0% after 12 months, and 82.2% after 36 months. Conclusion: TaTME can be performed safely with acceptable long-term oncological outcome. Low rectal cancer can be well addressed by TaTME, which is an appropriate alternative with low conversion, local recurrence, adequate mesorectal quality and CRM positivity rates.

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