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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
[Laparoscopic abdominoperineal resection for low rectal cancer]
Yi-fei Pan1, Xiao-hua Zhang, Xin-jian Jia
1Department of Oncology, The First Affiliated Hospital, Wenzhou Medical College, Wenzhou 325000, China. 13506641535@zj139.com
Summary
Laparoscopic abdominoperineal resection offers benefits for low rectal cancer patients, including less blood loss and fewer complications. This minimally invasive approach provides comparable oncological outcomes to open surgery.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Colorectal Surgery
Background:
- Low rectal cancer necessitates surgical intervention, with traditional open abdominoperineal resection (APR) being a standard approach.
- Laparoscopic techniques have emerged as an alternative, aiming to reduce surgical morbidity.
Purpose of the Study:
- To compare the advantages and disadvantages of laparoscopic APR versus open APR for patients with low rectal cancer.
Main Methods:
- A randomized controlled trial involving 74 patients with low rectal cancer (37 laparoscopic APR, 37 open APR).
- Key outcomes assessed included operation time, blood loss, recovery parameters (flatus, ambulation, discharge), complications, lymph node yield, recurrence rates, and cost.
Main Results:
- Laparoscopic APR demonstrated significantly less intra-operative blood loss and fewer postoperative complications (e.g., infections).
- Patients undergoing laparoscopic APR experienced earlier ambulation.
- No significant differences were observed in operation time, time to pass flatus, time to discharge, lymph node removal, or early recurrence between the groups.
- While initial operation costs were higher for laparoscopic APR, overall costs were comparable.
Conclusions:
- Laparoscopic APR is advantageous due to its minimally invasive nature, leading to reduced blood loss, fewer complications, and faster postoperative recovery.
- The oncological outcomes, including operation time and cost, are comparable to open APR, making it a viable alternative for low rectal cancer treatment.
