Dual-Ports Laparoscopy-Assisted Anterior Resection Compared with Conventional Laparoscopy-Assisted Anterior Resection for Rectal Cancer

Shigenori Homma, MD, N Minagawa, MD, T Shimokuni, MD, H Sakihama, MD, N Takahashi, MD, A Taketomi, MD, Prof

Hokkaido University Hospital, Department of Gastrointestinal Surgery I, Sapporo, Japan

Background: Reduced port laparoscopic surgery for acute appendicitis or GB stones was reported which was better cosmetic result, because of invisible scar, less invasive than conventional laparoscopic surgery. However, reduced port laparoscopic rectal surgery has not yet been standardized.

Purpose: We performed laparoscopic anterior resection using an umbilical port in addition with another port (dual-ports laparoscopy-assisted anterior resection, DP-AR) since August 2010. The aim of this study was to evaluate the feasibility of DP-AR compared with conventional laparoscopy-assisted anterior resection (C-AR).

Methods: The indication for DP-AR was preoperative clinical Stage 0-III rectal cancer. Short-term outcomes of 20 patients who underwent DP-AR were retrospectively compared with that of 20 patients of clinical Stage 0-III patients who underwent C-AR.
Results: Average age (years old) of DP-AR was 66.4, C-AR 68.7. Pre operative BMI (kg/m2) of DP-AR was 23.5, C-AR 23.9. Operative time of DP-AR was 187 minutes, C-AR 222 minutes. Blood loss of DP-AR was 22ml, C-AR 34ml. The number of lymph node dissection of DP-AR was 13.3, C-AR 14.5. The size of tumor of DP-AR was 36.5 mm, C-AR 33.8 mm. The rate of sub-serosal invasion of DP-AR was 60%, C-AR 45%. The rate of lymph node metastasis in DP-AR was 25%, C-AR 30%. The length of distal margin of DP-AR was 32mm, C-AR 28.6mm. The rate of conversion to open surgery rate of DP-AR was 10%, C-AR 0%. Post operative complications of both groups were none. The length of post operative hospital stay was 11.3 day (DP-AR), 11.2 day (C-AR). There were no significant differences in all patient’s and operative variables between DP-AR and C-AR.

Conclusions: Our early experiences suggested that DP-AR for rectal cancer might be a technically feasible and safe procedure for Stage 0-III rectal cancers.

Session: Poster Presentation

Program Number: P037

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