Song Liang, MDPHD1, Morris Franklin, Jr, MDFACS2. 1Fastrack Medical, 2Texas Endosurgery Institute
Background and Objectives: The present study was aimed at investigating the safety and feasibility of laparoscopic ultra-low anterior resection (L-ULAR) with total mesorectal excision (TME) and transanal specimen extraction for rectal cancer located at lower one-third rectum, and specifically understanding the oncological outcome of the operation.
Patients and Method: A prospective designed database of a consecutive series of patients undergoing laparoscopic ultra-low anterior resection for rectal malignancy with various tumor-node-metastasis (TNM) classifications from 1991 to 2012 at the Texas Endosurgery Institute was analyzed. In this study ultra-low anterior resection is defined as low anterior resection for the malignant lesion at distal 1/3 of rectum.
Results: 51 ultralow anterior resections were completed laparoscopically with TME and transanal specimen extraction. The operating time for the surgery was 169.7 +/- 31.1 minutes, and estimated blood loss during the procedure was 104.5 +/- 72.1 ml. The length of the lesion from the anal verge measured with intraoperative colonoscopy ranged from 3.5 cm to 6.9 cm, and shortest distance of colorectal anastomosis from the anal verge is 1 cm. Since diverting ileostomy was routinely installed after L-ULAR, none was found to have anastomotic leakage, however 3 patients developed anal stenosis within 6-month follow-up. Therefore the overall rate of postoperative complication is 5.9%. Moreover 4 patients were reported to have local recurrence in 2-year follow-up with the rate of 7.8%.
Conclusions: L-ULAR is safe and effective procedure for the rectal cancer at distal 1/3 rectum with comparable local recurrence and postoperative complication rates, thereby suggesting L-ULAR can be considered as a procedure of choice for rectal cancer at very low location in the rectum.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88615
Program Number: P200
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster