Single port transanal surgery for rectal lesions

Francisco Lopez-Kostner, MD, Alejandro Zarate, MD, Camila Estay, FellowResearch, Udo Kronberg, MD, Claudio Wainstein, MD

Clinica las Condes

Introduction: Rectal tumors may be approached by different techniques and transanal resection is mostly used when diagnosis is at early stages. One important disadvantage is limited vision and variable results concerning oncologic safety.
Objective: Analyze surgical results in patients with transanal excision using single port transanal surgery (SPTS).

Methods: transversal study. Using a prospective database of patients operated in the Colorectal Unit, between September 2011 and February 2012, patients with transanal SALP were selected. Demographic, clinical, surgical and histological information was analyzed in addition to short term follow up.

Results: Five patients were operated using SPTS, 3 women and 2 men. Mean age was 60 years (r: 44 – 70 years). Surgical indication was as follow: 3 patients with suspected rectal carcinoid, 1 villous adenoma and 1 recidivated rectal polyp. Three patients had history of previous endoscopic resection of rectal polyps, being in 2 of them an incomplete resection with a positive biopsy for rectal carcinoid, the other patient had recidivated villous adenoma. Rectal lesions were localized in 80% of the patients in inferior segment of the rectum and the rest in mid segment. Mean operating time was 48.8 minutes (r: 39 – 65 minutes). Hospital days were of 1 day in 2 patients and 2 days in three patients. One patient had postsurgical rectal bleeding (resolved by endoscopy). Regarding biopsies, in 2 patients rectal carcinoid was informed, 2 had a villous adenoma (with mid and severe dysplasia respectively) and 1 hyperplasic polyp. Every excision demonstrated lesion free surgical limits and in one case surgical piece included the whole lesion. After 3 month of follow up, neither postsurgical complications nor local recidivate were registered.

Conclusion: Transanal excision of rectal lesions using single laparoscopic port is feasible and has high-quality short term results.

Session: Poster Presentation

Program Number: P119

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