Short-term outcome of laparoscopic abdominoperineal resection for lower rectal cancer

Shinobu Ohnuma, MD, PhD, Tomoya Abe, MD, PhD, Hideaki Karasawa, MD, PhD, Kazuhiro Watanabe, MD, PhD, Hirifumi Imoto, MD, PhD, Takeshi Aoki, MD, PhD, Katsuyoshi Kudoh, MD, PhD, Masaharu Ishida, MD, PhD, Naoki Tanaka, MD, PhD, Munenori Nagao, MD, PhD, Hiroaki Musha, MD, PhD, Fuyuhiko Motoi, MD, PhD, Takeshi Naitoh, MD, PhD, Michiaki Unno, MD, PhD. Tohoku University Graduate School of Medicine

[Aim] To reveal short-term outcome of laparoscopic abdominoperineal resection (lap-APR) for patients with lower rectal cancer.

[Materials and Methods] Perioperative factors and clinicopathological features of eleven patients (4 male and 7 female, median age was 71 years old [17-85]) who had lap-APR in Tohoku University Hospital from 2008 to 2015 were compared to those of forty-four patients with open-APR in the same period.

[Results] Patient’s stage of lap-APR group was I/II/III/IV = 8:1:2:0. On the other hand, that of open-APR group was I/II/III/IV = 8:12:14:10, suggesting that lap-APR tended to be performed for patients with early stage disease. Patients in lap-APR showed statistically less blood-loss (64 vs 1030 ml, p<0.0001) and significantly shorter operative time than that of open-APR (291 vs 385 min, p=0.0256). There was no significant difference between lap-APR and open-APR in hospital-length of stay (22 vs 33 days, p = 0.19). Post-operative complications were less in lap-APR; Clavien-Dindo grade >or=3 was 9% in lap-APR and 32% in open-APR, respectively.

[Conclusion] Although further large clinical studies are needed, this retrospective study suggests that lap-APR is safe and less invasive approach for the patients with lower rectal cancer.

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