[Long-term efficacy of laparoscope-assisted transanal total mesorectal excision for rectal cancer].

Abstract

OBJECTIVE:

To investigate the long-term outcome of laparoscope-assisted transanal total mesorectal excision (taTME) for rectal cancer.

METHODS:

Clinicopathological data of 29 patients with mid-low rectal cancer undergoing laparoscope-assisted taTME at Department of Gastrointestinal Surgery, the First Affiliated Hospital of Guangzhou Medical University from May 2010 to December 2015 were collected for the retrospective case-series study. All the operations were performed with transabdominal and transanal procedure simultaneously or sequentially. Perioperative presentations, pathological examinations, and oncologic outcomes were retrospectively analyzed. Long-term recurrence, metastasis and survival were assessed during follow-up. Outpatient clinic and telephone survey were used for follow-up. The follow-up time ended in December 2018. The overall survival (OS) rate and disease-free survival (DFS) rate were calculated by the Kaplan-Meier method.

RESULTS:

The average intra-operative blood loss was (75.9±9.5) ml (range,20 to 200). The average operating time was (223.6±4.1) minutes (range, 165 to 280). The average number of harvested lymph node was 22.3±2.0. The average length of pathological specimen was (13.1±0.6) cm. The average distal resection margin was (2.9±0.2) cm. 89.7% (26/29) of specimens was complete and 10.3% (3/29) near complete. Two cases (6.9%) had positive cutting circumferential margin. Median follow-up was 56 (range, 22 to 91) months. Local recurrence rate, distant metastasis rate, 3-year OS rate, 3-year DFS rate, 5-year OS rate, 5-year DFS rate were 10.3% (3/29), 20.7%(6/29), 96.6%, 83.2%, 87.6% and 79.6%, respectively. No incisional hernia or adhesive intestinal obstruction was found.

CONCLUSION:

Long-term outcomes of mid-low rectal cancer patients undergoing laparoscope-assisted taTME are satisfactory.

• Authors: Dachao Zhang, Yuanguang Chen, Ming Hu, Jiongqiang Huang, Tongyi Xia, Zhiwei Ye, Guangming Wen, Gaofang Zhan, Jian Lei, Yike Zeng, Jinsong Chen, Chuanfeng Ke
• Journal: Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery (Zhonghua Wei Chang Wai Ke Za Zhi) Vol. 22 Issue 3 Pg. 262-266 (Mar 25 2019) ISSN: 1671-0274 [Print] China
• PMID: 30919379 (Publication Type: Journal Article)

Topics

• Humans
• Laparoscopes
• Neoplasm Recurrence, Local
• Rectal Neoplasms (surgery)
• Rectum
• Retrospective Studies
• Transanal Endoscopic Surgery