Multimedia article. Laparoscopic abdominoperineal resection for lower rectal cancers: how do we do it?

Surgical Endoscopy
J-T LiangP-H Lee

Abstract

The appropriateness of the laparoscopic approach for the resection of rectal cancer has been controversial, although it is well established in colon cancer. This is a phase II study of laparoscopic abdominoperineal resection (APR) in the treatment of lower rectal cancers. Patients with lower rectal adenocarcinoma located within 6 cm above the anal verge were recruited and subjected to laparoscopic APR. The surgical principle included en bloc resection with high ligation of inferior mesenteric vessels by no-touch isolation and total mesorectal excision. Details of the surgical procedures are presented in the video. The technical efficiency and outcome of this surgical approach were evaluated prospectively. This study was approved by the institutional review board of National Taiwan University Hospital (NTUH). A total of 22 patients were enrolled in the study from January 2003 to December 2004 under the ethical guidelines of clinical trials in NTUH. There were 12 females and 10 males, with an age distribution of 62.5 +/- 10.4 years. The body mass index was 24.8 +/- 4.0 kg/m2. Physical status (American Society of Anesthesiology classification) was class I in 12, class II in eight, and class III in two patients. Tumor size was 44.0...Continue Reading

References

Mar 8, 2000·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·W SjoerdsmaC A Grimbergen
Nov 15, 2002·Diseases of the Colon and Rectum·Richard P BakerJohn R T Monson
Sep 19, 2003·Journal de chirurgie·M Mathonnet, V Fermeaux
May 14, 2004·The New England Journal of Medicine·UNKNOWN Clinical Outcomes of Surgical Therapy Study GroupDavid Ota

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