Totally Laparoscopic Resection for Low Sigmoid and Rectal Cancer Using Natural Orifice Specimen Extraction Techniques

Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):e74-e79. doi: 10.1097/SLE.0000000000000438.

Abstract

Background: A minilaparotomy for specimen extraction during laparoscopy occasionally results in postoperative wound complications. We have performed a totally laparoscopic resection for early colorectal cancer using the natural orifice specimen extraction technique.

Methods: From 2008 to 2013, we have performed a totally laparoscopic resection for clinical stage I and IIA low sigmoid colon and rectal cancers. A prospectively maintained database was reviewed to assess the outcomes after surgery.

Results: In total, 40 patients had high anterior resections using transanal specimen extraction, and 32 patients had low anterior resections with transanal pull-through. Eight patients (11%) reported conversion to conventional laparoscopic colorectal resections; anastomotic leakages occurred in 4 patients (5.6%). No mortality or cancer recurrence was observed during 42.5±16.2 months of follow-up.

Conclusions: One natural orifice specimen extraction technique, known as transanal specimen extraction, has emerged as a promising form of totally laparoscopic surgical intervention for early-stage cancers of the low sigmoid colon and rectum.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Body Mass Index
  • Feasibility Studies
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Natural Orifice Endoscopic Surgery / methods*
  • Operative Time
  • Prospective Studies
  • Rectal Neoplasms / surgery*
  • Sigmoid Neoplasms / surgery*
  • Treatment Outcome