scholarly journals Anal function-preserving subtotal intersphincteric resection/partial external sphincteric resection with hybrid 2-port hand-assisted laparoscopic surgery (Mukai's operation) for very low stage I rectal cancer: A case report

Author(s):  
Masaya Mukai
Author(s):  
Mohammed Alessa ◽  
Hyeon Woo Bae ◽  
Homoud Alawfi ◽  
Ahmad Sakr ◽  
Forzan Sauri ◽  
...  

2021 ◽  
Author(s):  
Tadahiro Kojima ◽  
Hitoshi Hino ◽  
Akio Shiomi ◽  
Hiroyasu Kagawa ◽  
Yusuke Yamaoka ◽  
...  

Abstract Background Sphincter-preserving operations for ultra-low rectal cancer include low anterior resection and intersphincteric resection. In low anterior resection, the distal rectum is divided by a transabdominal approach, which is technically demanding. In intersphincteric resection, a perineal approach is performed. We aimed to evaluate whether robotic-assisted surgery is technically superior to laparoscopic surgery for ultra-low rectal cancer. The frequency of conducting low anterior resection by a specific procedure can indicate the technical superiority of that procedure for ultra-low rectal cancer. Thus, we compared the frequency of low anterior resection between robotic-assisted and laparoscopic surgery in cases of sphincter-preserving operations. Methods We investigated 183 patients who underwent sphincter-preserving robotic-assisted or laparoscopic surgery for ultra-low rectal cancer (lower border within 5 cm of the anal verge) between April 2010 and March 2020. The frequency of low anterior resection was compared between laparoscopic and robotic-assisted surgeries. The clinicopathological factors associated with an increase in performing low anterior resection were analyzed by multivariate analyses. Results Overall, 41 (22.4%) and 142 (77.6%) patients underwent laparoscopic and robotic-assisted surgery, respectively. Patient characteristics were similar between the groups. Low anterior resection was performed significantly more frequently in robotic-assisted surgery (67.6%) than in laparoscopic surgery (48.8%) (p = 0.04). Multivariate analyses showed that tumor distance from the anal verge (p < 0.01) and robotic-assisted surgery (p = 0.02) were significantly associated with an increase in the performance of low anterior resection. The rate of postoperative complications or pathological results was similar between the groups. Conclusions Compared with laparoscopic surgery, robotic-assisted surgery significantly increased the frequency of low anterior resection in sphincter-preserving operations for ultra-low rectal cancer. Robotic-assisted surgery has technical superiority over laparoscopic surgery for ultra-low rectal cancer treatment.


2021 ◽  
Vol 86 ◽  
pp. 106331
Author(s):  
Tomoyuki Sugi ◽  
Yohei Owada ◽  
Tsuyoshi Enomoto ◽  
Yusuke Ohara ◽  
Yoshimasa Akashi ◽  
...  

2009 ◽  
Vol 52 (1) ◽  
pp. 64-70 ◽  
Author(s):  
Masaaki Ito ◽  
Norio Saito ◽  
Masanori Sugito ◽  
Akihiro Kobayashi ◽  
Yusuke Nishizawa ◽  
...  

2020 ◽  
Author(s):  
Baifu Peng ◽  
Zixin Wu ◽  
Zijian He ◽  
Guanwei Li ◽  
Jie Cao ◽  
...  

Abstract Purpose In recent years, intersphincteric resection (ISR) has been increasingly used to replace abdominoperineal resection (APR) for low rectal cancer. This study was to compare the clinical efficacy of ISR and APR. Methods Between 2012 and 2018, 74 consecutive patients with low rectal cancer underwent ISR and APR in our medical centre. The outcomes were retrospectively studied and compared. Results A total of 43 patients underwent ISR and 31 underwent APR were included in the study. No significant differences were found between two groups in gender, age, BMI and ASA score. ISR group showed shorter operative time (P = 0.02) and less blood loss (P = 0.001). Hospital stays, time to soft diet, and postoperative thirty-day complications were not significantly different between the two groups. As for the long-term outcomes, the survival and recurrence rate were similar between two groups. Moreover, LARS score and Wexner score showed the anal function after ISR was generally satisfactory. Conclusion This study suggested that ISR may provide a feasible alternative to APR, with superior short-term outcomes, similar oncological outcomes and satisfactory postoperative anal function.


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