Laparoscopic abdominoperineal resection of the rectum - how is it done; initial results

Pol Przegl Chir. 2013 Oct;85(10):569-75. doi: 10.2478/pjs-2013-0085.

Abstract

The abdominoperineal resection of the rectum is a classical operation performed in case of patients diagnosed with rectal cancer. The development of laparoscopic techniques in recent years, introduced yet another method of treatment, considering patients with rectal cancer- laparoscopic abdominoperineal resection of the rectum. The aim of the study was to present initial treatment results considering the above-mentioned patients.

Material and methods: The study group comprised 25 patients (16 male and 9 female) diagnosed with low-rectal cancer, subjected to surgery by means of the above-mentioned method. Mean patient age amounted to 66 years. Three (12%) patients required conversion to classical surgery (laparotomy), while one patient required reoperation, due to presacral vascular bleeding. Complications were observed in 10 (40%) patients. Average hospitalization was 7 days. In case of all patients the radial margin was negative, and mean number of removed lymph nodes amounted to 9.6. Mortality was not observed during the perioperative period. Due to the initial character of the study analysis (mean observation period in case of 68% of patients was shorter than 2 years), oncological results were not subject to evaluation.

Conclusions: Laparoscopic abdominoperineal resections are considered as technically difficult operations, requiring significant experience of the operating team. However, they enable the patient to take advantage of the many assets of minimally invasive surgery, with comparable rates of postoperative complications.

Publication types

  • Clinical Study

MeSH terms

  • Adenocarcinoma / secondary
  • Adenocarcinoma / surgery*
  • Aged
  • Conversion to Open Surgery
  • Digestive System Surgical Procedures / methods
  • Female
  • Humans
  • Laparoscopy / methods
  • Length of Stay
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Pneumothorax, Artificial
  • Prospective Studies
  • Rectal Neoplasms / surgery*
  • Rectum / surgery*
  • Reoperation
  • Treatment Outcome