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Laparoscopic Rectal Surgery: Different Outcome in Relation to Gender?.

Introduction: A classic limitation in the surgical approach to the rectum is the different anatomy between male and female. In the open era, several studies have shown the importance of sex anatomy on the outcome, considering male sex as independent factor for leak . These difficulties are exaggerated during the laparoscopic approach, The aim of this study has been to compare the immediate outcome after the laparoscopic approach to the rectum according the sex of the patient. Materials & methods: Prospective analysis of 230 patients diagnosed of rectal cancer approached by laparoscopy between jan-98 to Dec 07. Study variable were : age, sex, IBM, op. time, type of resection (Ant resection (AR), low AR (LAR) and Miles procedure (APR), conversion, stay, morbidity (Dindo score), reop, mortaility and nº of lymph nodes retrieved. Results: 152 men and 77 females, Median age was 70 (male, 69 vs 70 female, ns), mean BMI was 25,41 (25,5 m vs 25,2 f), Conversion rate was 28% (27,6% m vs 30% f, ns), Op time was 180 min (184 m vs 167 f, p< .001), AR: 28%, LAR 38% and Miles 34% without differences between male and female. Mean lymph nodes10, without differences between male and female s. Reop rate was 8,6%, (10 % in females vs 7,8% in males). Morbidity after RA and LAR: el 11% (6/56) in males vs 20% (6/30) in woman. Mortality: 3 in males vs 0 in females, ns . Mean stay was 10 d in men vs 9 in females. Conclusion:, Rectal cancer in the male approached by laparoscopy entails a greater difficulty confirmed by longer operative time. However, this fact do not have impact on the conversion rate, reoperation, morbidity or leakage . We consider that laparoscopic approach may be offered with security for most patients diagnosed of rectal cancer.


Session: Poster

Program Number: P125

57

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