scholarly journals The role of transanal drainage tube in low anterior resection for rectal cancer

2021 ◽  
Vol 102 (3) ◽  
pp. 335-341
Author(s):  
F Sh Akhmetzyanov ◽  
V I Egorov ◽  
D M Ruvinskiy ◽  
O V Lûtikovа
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colorectal Anastomosis ◽  
Small Samples ◽  
Mesorectal Excision ◽  
Surgical Interventions ◽  
Anterior Rectal Resection ◽  
Intestinal Stoma

Total mesorectal excision with low anterior resection has significantly improved the long-term outcomes of surgical treatment for rectal cancer, decreasing the local recurrence rate and increasing survival. However, total mesorectal excision is becoming one of the main factors for the development of colorectal anastomosis leakage, the rate of which reaches 20% in these operations. To minimize the complications associated with the inconsistency of the colorectal anastomotic suture, preventive intestinal stoma is formed when performing low anterior resections. That significantly worsen the quality of life of patients, their elimination requires re-hospitalization, and surgical interventions are accompanied by a high incidence of postoperative complications, reaching a rate of 20%, which has a significant impact on the cost of treatment for this category of patients. Transanal drainage is an alternative to the formation of preventive intestinal stoma and is devoid of its shortcomings. This literature review is devoted to an analysis of the effectiveness of transanal drainage in low anterior rectal resection. Until recently, transanal drainage has not yet gained popularity among surgeons due to the lack of evidence of its safety and effectiveness, and many studies are retrospective, including small samples. The review considered single-center, multicenter, randomized trials and a meta-analysis of the use of transanal drainage. Transanal drainage is an effective method for preventing the inconsistency of colorectal anastomotic suture, it is safe, and it surpasses the preventive intestinal stoma in a number of indicators.

Push-Back Technique Facilitates Ultra-Low Anterior Resection without Nerve Injury in Total Mesorectal Excision for Rectal Cancer

2011 ◽  
Vol 28 (4) ◽  
pp. 239-244 ◽  
Author(s):  
Yasuhiro Inoue ◽  
Junichiro Hiro ◽  
Yuji Toiyama ◽  
Koji Tanaka ◽  
Keiichi Uchida ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Total Mesorectal Excision ◽  
Nerve Injury ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Mesorectal Excision

scholarly journals Single-incision Plus One Port Laparoscopic Total Mesorectal Excision and Bilateral Pelvic Node Dissection for Advanced Rectal Cancer—A Medial Umbilical Ligament Approach

2015 ◽  
Vol 100 (3) ◽  
pp. 417-422 ◽  
Author(s):  
Masayoshi Tokuoka ◽  
Yoshihito Ide ◽  
Mitsunobu Takeda ◽  
Yasuji Hashimoto ◽  
Jin Matsuyama ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Lymph Nodes ◽  
Total Mesorectal Excision ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Single Incision ◽  
Advanced Rectal Cancer ◽  
Laparoscopic Total Mesorectal Excision ◽  
Node Dissection ◽  
Mesorectal Excision

We prove the safety and feasibility of single-incision plus 1 port (SILS+1) laparoscopic total mesorectal excision (TME) + lateral pelvic lymph node dissection (LPLD) via a medial umbilical approach for rectal cancer. Only a few reports have been published about single-incision multiport laparoscopic low anterior resection with LPLD. Recently, minimally invasive surgery such as single-incision plus 1 port (SILS + 1) for advanced rectal cancer has been reported as safe and feasible. To our knowledge, this is the first reported case of SILS + 1 used for LPLD. A wound protector was inserted through a 30-mm transumbilical incision. Next, a single-port access device was mounted to the wound protector and 3 ports (5 mm each) were placed. A 12-mm port was inserted in the right lower quadrant. Super-low anterior resection of the rectum and bilateral LPLD and temporary ileostomy were performed with SILS + 1, with a blood loss of 50 mL and a total surgical time of 525 minutes. The time for right lateral dissection was 74 minutes; the time for left lateral dissection was 118 minutes. The total number of dissected lymph nodes was 57 and the number of lateral lymph nodes dissected was 21 (8 left pelvic lymph nodes, 13 right pelvic lymph nodes). No postoperative anastomotic insufficiency or voiding dysfunction was observed. We have documented the safety and feasibility of SILS + 1-TME + LPLD via a medial umbilical approach for rectal cancer.

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