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Laparoscopic total mesorectum excision.

J A Reis Neto1, F A Quilici, F Cordeiro

  • 1Clínica Reis Neto, Brazilian Colorectal Laparoscopic Surgeons. reisneto@Lexxa.com.br

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|July 13, 2002
PubMed
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Laparoscopic surgery for rectal cancer offers effective tumor resection comparable to open surgery. This study found no port-site tumor implantation, supporting its routine use in cancer treatment.

Area of Science:

  • Colorectal Surgery
  • Surgical Oncology
  • Minimally Invasive Surgery

Background:

  • Laparoscopic surgery for rectal cancer faces controversy regarding port-site metastasis and radical resection.
  • Key concerns include tumor implantation at trocar sites and the feasibility of total mesorectum excision.

Purpose of the Study:

  • To evaluate the safety and efficacy of laparoscopic total mesorectum excision for lower rectal cancer.
  • To assess port-site tumor implantation and local recurrence rates in a specialized protocol.

Main Methods:

  • A protocol involving 32 patients with lower rectal cancer underwent preoperative radiotherapy and laparoscopic total mesorectum excision.
  • Data were compared with a multicenter experience of 130 patients with lower rectal tumors.

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Main Results:

  • Laparoscopic approach achieved effective resection comparable to conventional surgery.
  • Preoperative radiotherapy did not increase intraoperative complications.
  • Average of 12.3 lymph nodes were dissected, similar to open surgery.
  • Local recurrence rate was 3.12% with no port-site tumor implantation observed.

Conclusions:

  • Laparoscopic total mesorectum excision is a viable and safe option for treating lower rectal cancer.
  • The technique allows for radical cancer surgery without increased risk of port-site metastasis.