Related Experiment Video
Updated: Sep 17, 2025
Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
Short-Term and 3-Year Oncological Outcomes in Laparoscopic-Assisted Trans-Anal Pelvic Exenteration With Preserving
Takashi Nonaka1, Tetsuro Tominaga1, Toshio Shiraishi1
1Department of Surgical Oncology, Nagasaki University Graduate School of Biological Sciences, Nagasaki, Japan.
Purpose:
Pelvic exenteration (PE) for rectal cancer is highly invasive. The trans-anal approach (Ta-PE) offers a minimally invasive alternative. This study evaluates the perioperative and long-term outcomes of laparoscopic-assisted Ta-PE.
Methods:
A retrospective analysis was conducted on 17 patients who underwent laparoscopic-assisted Ta-PE with preserving anal sphincter between April 2018 and September 2024. Perioperative and oncological outcomes, including operative time, complications, hospital stay, and survival rates, were assessed.
Results:
The median age was 64 years (nine men, eight women). Total-PE was performed in 11 patients (64.7%), and posterior-PE in 6 (35.3%). Urinary diversion was required in 13 (76.5%). Mean operative time was 464 min, with no conversions. Clavien-Dindo Grade III-IV complications occurred in four cases (23.5%), including pelvic abscess (n = 3) and postoperative bleeding (n = 1). No reoperations or 90-day mortality were observed. The median hospital stay was 21 days. Three-year overall survival, disease-free survival, and local control rates were 69.9%, 45.4%, and 93.8%, respectively.
Conclusion:
Laparoscopic-assisted Ta-PE is a promising minimally invasive option for locally advanced rectal cancer, with favorable perioperative outcomes and effective local disease control. Larger studies are needed to confirm these findings and refine patient selection.
