Related Experiment Videos
[Total meso-rectal excision in low anterior resection with double stapling technique]
1Institute of Digestive Surgery, Affiliated Ruijin Hospital, Shanghai Second Medical University, Shanghai 200025, China.
Objective:
To elucidate the value of total meso-rectal excision (TME) in low anterior resection with double stapling technique.
Methods:
During January 1993 to October 1998, 306 cases of rectal lesions were treated by total meso-rectal excision in low anterior resection (LAR) with double stapling technique. Among the patients with rectal cancer, 235 (78.86%) were treated by low anterior resection and 97 (41.28%) by ultra-low anterior resection.
Results:
No operative death was noted, and anastomotic leakage occurred in 9 (2.94%) patients. Ureter injury occurred in 2 (0.65%) patients. 32 (10.46%) patients suffered from anastomotic stenosis, 31 mm diameter of stapler for 27 (12.68%) patients and 33 mm diameter of stapler for 5 patients (5.38%). Local recurrence occurred in 20 (6.71%) patients: Dukes'B 4 (2.33%) patients, Dukes'C 9 (12.5%) patients, and Dukes'D 7 (53.85%) patients.
Conclusions:
Total meso-rectal excision can effectively reduce the local recurrence rate after LAR with double stapling technique. Since the recurrence is closely related to the stage of the disease, early detection, early diagnosis and early treatment are extremely important.