Laparoscopic Radical Resection of Rectal Carcinoma:Report of 80 Cases / 中国微创外科杂志

ABSTRACT

Objective To investigate the feasibility and safety of laparoscopic radical resection for rectal carcinoma.Methods A total of 80 patients with rectal carcinoma received laparoscopic radical resection in our hospital from March 2004 to January 2008.During the operation,adequate proximal and distal bowel segments,and mesentery and lymph nodes surrounding the tumor were resected completely.And then lower anterior resection(Dixon)and sigmoid colostomy for abdominal perineal resection(Miles)were implemented.Results Among the 80 patients,4 were converted to open surgery during the operation,and the other 76 patients were treated by laparoscopy successfully.Dixon surgery was performed on 44 cases with a mean operation time of(178?38)minutes,intraoperative blood loss of(61?17)ml,excised lymph nodes number of(11.3?2.9),and postoperative hospital stay of(7.1?3.2)days.Miles were carried out on 32 patients,in which the mean operation time was(231?49)minutes and intraoperative blood loss was(210?178)ml;a mean of(12.9?3.7)lymph nodes were resected,the postoperative hospital stay was(9.3?4.1)days.No residual cancer was found in the patients.After the treatment,1 patient developed stoma stenosis,5 showed perineal wound infection,1 had anastomotic leak,and 6 complained of urinary retention immediately after the surgery.No patient had postoperative hemorrhage or died after the procedure.Follow-up was achieved in 70 cases for 9 to 48 months,during which 5 patients had recurrence,2 died of multiple organ failure induced by multiple metastasis,and 5 patients developed ileus.Conclusion Laparoscopic resection for rectal carcinoma is safe and feasible for selected patients,when the surgeons are skilled with experience on both open colectomy and laparoscopic surgery.