Laparoscopic- vs. hand-assisted ultralow anterior resection: a prospective study

Area of Science:

• Colorectal Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Laparoscopic-assisted surgery is a standard approach for rectal cancer resection.
• Colorectal anastomosis can be performed via different laparoscopic techniques, including standard and hand-assisted methods.

Purpose of the Study:

• To compare the short-term outcomes of standard laparoscopic-assisted surgery versus hand-assisted laparoscopic surgery for rectal cancer.
• To evaluate operative time, recovery parameters, and complication rates between the two techniques.

Main Methods:

• A comparative study of 63 consecutive patients undergoing laparoscopic-assisted ultralow anterior resection or total mesorectal excision for rectal cancer.
• Patients were divided into two groups: standard laparoscopic-assisted resection (n=31) and hand-assisted laparoscopic resection with a 7-8 cm suprapubic incision (n=32).
• Diverting ileostomy was performed in all patients.

Main Results:

• No conversions to open surgery were required in either group.
• Hand-assisted laparoscopic surgery demonstrated a significantly shorter mean operating time (169.8 minutes) compared to standard laparoscopic-assisted surgery (188.2 minutes).
• Recovery parameters such as duration of narcotic analgesia, time to flatus, and intravenous hydration were shorter in the hand-assisted group, with similar hospital stays and complication rates.

Conclusions:

• Both standard laparoscopic-assisted and hand-assisted laparoscopic techniques are safe and feasible for ultralow anterior resection in rectal cancer patients.
• The hand-assisted laparoscopic approach offers a significant advantage in reducing operative time.