Abstract:
Objective To evaluate the role of laparoscopic transanal pull-through total mesorectal excision with double stapling surgery in patients with low/ultra-low rectal cancer.
Methods A total of 46 patients diagnosed with low/ultralow rectal cancer underwent laparoscopic transanal pull-through total mesorectal excision(TME) with double stapling technique.The data were retrospectively reviewed and analyzed in terms of the success rate, postoperative complications, and long term therapeutic outcome.
Results All operations were successfully accomplished laparoscopically.No conversion to an open procedure was required.The average operative duration was 167 min(range: 145 min to 228 min).The intraoperative blood loss volume was 42 mL(range: 20 mL to 55 mL).No immediate or delayed injury of the urinary duct or other severe intraoperative complications, such as massive hemorrhage of the presacral venous plexus, occurred.No anastomotic stoma fistula was observed during the postoperative period.The average follow-up period was 12.6 mo.No stomal leak, ureteral injury, or trocar implantation metastasis occurred.To date, none of the cases have local recurrence.
Conclusion Laparoscopic transanal pull-through TME with double stapling surgery is a safe and efficient method for treating low and ultra-low rectal cancer.The method allows preservation of a sufficient distal section margin of the tumor.
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