Short Term Outcome of Laparoscopic Anterior Resection for Rectal Carcinoma

Colorectal cancer is the second most common malignancy in the western countries and the rectum is the most frequent site involved. Carcinoma in the rectosigmoid junction, upper and middle 3rd of the rectum is now successfully managed by laparoscopic AR and postoperative morbidities are less and recovery is uneventful. The advantages of laparoscopic surgery are smaller incisions, shorter recovery time and less wound related complications. However the narrow confines and angulations of the bony pelvis and the standard practice of autonomic nerve sparing total mesorectum excision has made laparoscopic surgery in the setting of rectal cancer more challenging. This study was carried out in the Colorectal surgery Department, Bangabandhu Sheikh Mujib Medical University, Dhaka from April 2018 to March 2019. Forty (40) cases were selected according to inclusion criteria. Twenty (20) patients treated by conventional open AR were known as control group and rest 20 patients treated by laparoscopic AR were known as Experimental group. Patient's particulars, pre operative diagnosis, operative findings were recorded in a pre designed data sheet and postoperative follow up and early outcomes of the patients of both groups were recorded by the same manner to find out general and local complications till discharge. Postoperatively all the patients were referred to oncology department and advised to come for follow up after 2 weeks (1st follow up). Mean age of experimental group was 43.40 and standard deviation was 13.59. In both age groups, age was not a contraindication. In the both groups number of male is slightly higher than female. Laparoscopic anterior resection can be performed safely and effectively. During post-operative follow up no significant morbidities and complications were observed in post-operative period in both groups of population. Degree of pain along with use of analgesia is also less after laparoscopic AR. Ambulation, stoma function, feeding liquid and feeding solid all occurred earlier for experimental group. Mean length of hospital stay for experimental group was found to be shorter than that of control group. Early hospital discharge was possible after laparoscopic AR. Oncological parameters were equivalent to those of open procedures. Laparoscopic AR is acceptable for rectal carcinoma.