Clinical outcome of laparoscopic intersphincteric resection combined with transanal rectal dissection for t3 low rectal cancer in patients with a narrow pelvis

Kimihiko Funahashi; Hiroyuki Shiokawa; Tatsuo Teramoto; Junichi Koike; Hironori Kaneko

doi:10.1155/2011/901574

Clinical outcome of laparoscopic intersphincteric resection combined with transanal rectal dissection for t3 low rectal cancer in patients with a narrow pelvis

Int J Surg Oncol. 2011:2011:901574. doi: 10.1155/2011/901574. Epub 2011 Dec 29.

Authors

Kimihiko Funahashi¹, Hiroyuki Shiokawa, Tatsuo Teramoto, Junichi Koike, Hironori Kaneko

Affiliation

¹ Department of Gastroenterological Surgery, Toho University Medical Center, Omori Hospital, 6-11-1 Omorinishi Otaku, Tokyo 1438541, Japan.

Abstract

Purpose. The purpose of this study was to analyze the safety and feasibility of laparoscopic intersphincteric resection (ISR) combined with transanal rectal dissection (TARD) for T3 low rectal cancer in a narrow pelvis. Methods. We studied 20 patients with a narrow pelvis of median body mass index 25.3 (16.9-31.2). Median observation period was 23.6 months (range 12.2-56.7). Results. Partial, subtotal, and total ISR was performed in 15, 1, and 4 patients, respectively. Median duration of TARD was 83 min (range 43-135). There were no major complications perioperatively or postoperatively. Surgical margins were histologically free of tumor cells in all patients, and there was no local recurrence. Excluding urgency, frequency of bowel movements, and incontinence status improved gradually after stoma closure. Conclusion. Laparoscopic ISR combined with TARD is technically feasible for selective T3 low rectal cancer in patients with a narrow pelvis.