Inter-ischial spine distance is a simple index of narrow pelvis that may predict difficulty during laparoscopic low anterior resection: a retrospective study

Abstract Background A narrow pelvis makes laparoscopic rectal resection difficult. This study aimed to evaluate whether a simple measurement on computed tomography can predict procedural difficulty. Methods A total of 62 patients with low rectal cancer underwent conventional laparoscopic low anterior resection. The inter-ischial spine (IS) distance (i.e., distance between the ischial spines) was measured on an axial computed tomography slice. Operative time, blood loss, and time from insertion of linear staplers to completion of clamping on the distal end of the rectum (clamp time) were compared. Results Overall, 42 men and 20 women with low rectal cancer were assessed. The mean tumor size was 34.5 mm. Total or tumor-specific mesorectal excisions were performed in all cases; high ligation and resection of the inferior mesenteric arteries were carried out in 92% of patients. The mean operative time, and blood loss were 206 min, and 15 mL respectively. Four patients (6.5%) experienced postoperative complications, including two anastomotic leaks (3.2%). The mean IS distance was 93.3 mm. With simple linear regression, shorter IS distance correlated with longer operative time (R2 = 0.08, P = 0.030) and clamp time (R2 = 0.07, P = 0.046). Using an receiver operating characteristic curve, a narrow pelvis was defined as IS distance < 94.7 mm. Multivariate regression analysis revealed that IS distance < 94.7 mm (odds ratio, 3.51; P = 0.04) was independently associated with a longer clamp time. Conclusions The IS distance is a simple and useful measurement for predicting the difficulty of laparoscopic low anterior resection.

Download Full-text

Đánh giá chất lượng cuộc sống của bệnh nhân ung thư trực tràng trên và giữa được điều trị phẫu thuật nội soi cắt trực tràng trước thấp

Journal of Clinical Medicine- Hue Central Hospital ◽

10.38103/jcmhch.2020.66.5 ◽

2020 ◽

Author(s):

Thong Tran Ngoc

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Overall Survival Rate ◽

Central Hospital ◽

Laparoscopic Low Anterior Resection ◽

The Mean

Introduction: Evaluation of the quality of life of patients with upper and middle rectal cancer treated with laparoscopic low anterior resection. Material and method: Prospective and previous research from 1/2013 to 9/2019 at Hue central hospital, a laparoscopic low anterior resection was performed in 86 patients with upper and mid rectal cancer. Result: There were 40 males and 45 females with the mean age of 62,95 ± 13,13; no conversion, have seven cases anastomotic leakage. Mean follow-up duration 60 months: have five cases local recurrence (5,9%), the overall survival rate after 5 years was 45%. Quality of Life of Patients is quiet good. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, quality of life of patient is quite good.

Download Full-text

EVALUATION THE RESULTS OF LAPAROSCOPIC LOW ANTERIOR RESECTION FOR TREATMENT UPPER AND MIDDLE RECTAL CANCER

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.5.25 ◽

2017 ◽

pp. 182-189

Author(s):

Ngoc Thang Tran ◽

Ngoc Hung Dang ◽

Manh Ha Le ◽

Anh Vu Pham ◽

Nhu Hiep Pham ◽

...

Keyword(s):

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Overall Survival Rate ◽

Central Hospital ◽

Laparoscopic Low Anterior Resection ◽

Rectal Cancer Treatment ◽

The Mean ◽

Initial Results

Introduction: To evaluate the feasibility and benefits of laparoscopic low anterior resection for upper and middle rectal cancer treatment. Material and method: Prospective study from 8/2013 to 8/2017 at Hue Central Hospital, a laparoscopic low anterior resection was performed in 45 patients with upper and mid rectal cancer. Result: There were 29 males and 16 females with the mean age of 60.3 ± 11.5 (range 38 – 75), no conversion, have three cases anastomotic leakage, the mortaliy rate was 0%. Mean follow-up duration 36 months: have tow cases local recurrence (4.4%), the overall survival rate was 100%. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, initial results is good. Key words: upper and middle rectal cancer, Laparoscopic low anterior resection

Download Full-text

Risk and early predictive factors of anastomotic leakage in laparoscopic low anterior resection for rectal cancer

World Journal of Surgical Oncology ◽

10.1186/s12957-019-1716-3 ◽

2019 ◽

Vol 17 (1) ◽

Cited By ~ 4

Author(s):

Masahiro Fukada ◽

Nobuhisa Matsuhashi ◽

Takao Takahashi ◽

Hisashi Imai ◽

Yoshihiro Tanaka ◽

...

Keyword(s):

Rectal Cancer ◽

Multivariate Analysis ◽

Blood Loss ◽

Anastomotic Leakage ◽

Predictive Factors ◽

Anterior Resection ◽

Low Anterior Resection ◽

Univariate Analysis ◽

Intraoperative Blood Loss ◽

Laparoscopic Low Anterior Resection

Abstract Background In recent years, laparoscopic surgery has been widely used for rectal cancer. In laparoscopic rectal surgery, a double-stapling technique (DST) anastomosis using a stapling device is considered a relatively difficult procedure. Postoperative anastomotic leakage (AL) is a major complication related to patients’ quality of life and prognosis. Methods This study was a retrospective, single-institution study of 101 rectal cancer patients who underwent laparoscopic low anterior resection (LAR) with DST anastomosis (excluding simultaneous resection of other organs and construction of protective diverting stoma) between February 2008 and November 2017 at the Gifu University Graduate School of Medicine. This study aimed to identify risk and early predictive factors of AL. Results Among 101 patients, symptomatic AL occurred in 13 patients (12.9%), of whom 10 were male and 3 were female. Their median BMI was 22.7 kg/m2 (range, 17.9–26.4 kg/m2). Among the pre- and intraoperative factors, AL was significantly associated with tumor location (lower rectum), distance from the anal verge (< 6 cm), intraoperative blood loss (≥ 50 ml), and the number of linear staples (≥ 2) in univariate analysis. In multivariate analysis, only intraoperative blood loss (≥ 50 ml, odds ratio [OR] 4.59; 95% confidence interval [CI] 1.04–19.52; p = 0.045) was identified as an independent risk factor for AL. Among the postoperative factors, AL was significantly associated with tachycardia-POD1 (≥ 100 bpm), CRP-POD3 (≥ 15 mg/dl), fever on postoperative day (fever-POD) 3 (≥ 38 °C), and first defecation day after surgery (< POD3) in univariate analysis. In multivariate analysis, fever-POD3 (≥ 38 °C, OR 30.97; 95% CI 4.68–311.22; p = 0.0003) and first defecation day after surgery (< POD3, OR 5.82; 95% CI 1.34–31.30; p = 0.019) were identified as early predictive factors for AL. Conclusion In this study, intraoperative blood loss was an indicator of difficulty in a transection and anastomosing procedure, and fever-POD3 and early first defecation day after surgery were independent early predictive factors for AL. Careful surgery using an appropriate technique and standardized procedures with minimal bleeding and careful postoperative management paying attention to fever and defecation may prevent the onset and severity of AL.

Download Full-text

Laparoscopic low anterior resection for rectal cancer with rectal prolapse: a case report

Journal of Medical Case Reports ◽

10.1186/s13256-017-1555-1 ◽

2018 ◽

Vol 12 (1) ◽

Cited By ~ 3

Author(s):

Ryusei Yamamoto ◽

Yasuji Mokuno ◽

Hideo Matsubara ◽

Hirokazu Kaneko ◽

Shinsuke Iyomasa

Keyword(s):

Rectal Cancer ◽

Case Report ◽

Rectal Prolapse ◽

Anterior Resection ◽

Low Anterior Resection ◽

Laparoscopic Low Anterior Resection

Download Full-text

The impact of timing of stoma closure on low anterior resection syndrome in patient who underwent low anterior resection for rectal cancer

Kurdistan Journal of Applied Research ◽

10.24017/science.2021.1.13 ◽

2021 ◽

pp. 126-134

Author(s):

Hemn Hussain Kaka Ali ◽

Qalandar Hussein Abdulkarim ◽

Karzan Seerwan ◽

Barham M. M .Salih

Keyword(s):

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Anal Verge ◽

Loop Ileostomy ◽

Low Anterior Resection Syndrome ◽

Anterior Resection Syndrome ◽

Closure Of Ileostomy ◽

The Mean ◽

The Impact

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus. A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.

Download Full-text