Jing Sun, MD, PhD, Hiju Hong, Chaoran Yu, Junjun Ma, MD, PhD, Aiguo Lu, MD, PhD, Minhua Zheng, MD, PhD. Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
The Clinical data of 137 patients with rectal carcinoma who underwent laparoscopic radical resection in three Surgery Centers between May 2016 and September 2017 were randomized and analyzed prospectively, to investigate the operative technique, postoperative recovery, feasibility and safety of the Cephalo-Medial-to-Lateral approach in Laparoscopic Total Mesorectal Excision of Rectal Cancer.
Patients were divided into the following groups: Cephalo-Medial-to-Lateral approach group (CML group, n=63) and Medial-to-Lateral approach group (ML group, n=74). In the CML group (40 males, 23 females ), the average age was 61.68±10.38 (range 36-90 years); In the ML group (44 males, 30 females ), the average age was 62.05±11.96(range 38-86 years). There was no conversion to open, intraoperative complications or operation related death. In the CML group, the mean operative time was 103.11±22.40 min, and the mean blood loss was 97.89±53.35 ml. The mean hospitalization days was 9.48±5.04 days. In the ML group, the mean operative time was 101.37±20.27 min(P= 0.634), and the mean blood loss was 94.18±93.32 ml(P= 0.780). The mean hospitalization days was 10.08±6.92 days(P= 0.605). In the CML group, there were 2 cases with postoperative anastomotic leakage, while there were 8 cases in the ML group.
The mean number of dissected lymph nodes was 15.61±5.08 in CML group. The mean number of harvested LN.253 was 1.75±1.03, and the number of cases with metastatic LN.253 was 4 (7.14%) in CML group. The mean number of dissected lymph nodes was 15.71±4.89 in ML group(P=0.081). The mean number of harvested LN.253 was 15.71±4.89 (P= 0.904), and the number of cases with metastatic LN.253 was 4 (12.90%) in ML group.
All the cases were followed up for 0.5-15 months. During the follow-up period, there were 3 cases of recurrence in CML group and 2 cases in ML group; there were no cases of tumor-related death in both two groups.The midterm results concluded that the effect of Cephalo-Medial-to-Lateral approach in laparoscopic total mesorectal excision of rectal cancer was similar to the traditional Medial-to-Lateral approach. We look forward to the final result to thoroughly evaluate the oncological effect of this technique.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87723
Program Number: P248
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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