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26.07.2016 | Colorectal Cancer | Ausgabe 12/2016

Annals of Surgical Oncology 12/2016

Laparoscopic-Assisted Rectal Surgery for Rectal Cancer Using the Simple Rectum Catcher Device with an Intraoperative Colonoscopy: Results of Our Hospital Study in 203 Patients

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 12/2016
Autoren:
MD Akiyo Matsumoto, MD Kaida Arita
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1245/​s10434-016-5442-6) contains supplementary material, which is available to authorized users.

Abstract

Background

The gold standard of rectal surgery is TME and DST anastomosis.1 6 The division of mesorectum in tumor-specific mesorectal and total mesorectal excisions is one of the most difficult procedures of anterior dissection. We have developed a laparoscopic-assisted anterior dissection technique using the simple Rectum Catcher device (RC) with an intraoperative colonoscopy (CF).7 , 8

Methods

Surgical and oncological outcomes were compared between 99 patients undergoing a laparoscopic approach with the RC and a CF (RCF) and 104 patients undergoing the laparoscopic approach without the RC and without a CF (NRCF). Our standardized procedure for RCF is shown in the video.

Results

BMI (p = .025) and tumor diameter (p = .002) were significantly higher in the RCF group. However, operation times (p = .005) and time to tolerate diet (p = .009) were significantly shorter. Estimated blood loss was significantly decreased (p = .005) and quality of TME or TSME was significantly better (p = .017) in the RCF group. When we further analyzed surgical and oncological outcomes by dividing 3 parts of the rectum, patients with rectosigmoid (Rs) cancer and patients with cancer in the rectum below the peritoneal reflection (Rb) had comparable results. Particularly, statistically significant differences in length of operation time (p = .018), estimated blood loss (p = .050), quality of TME or TSME (p = .017), time to tolerate diet (p = .010), and R0 resections (p = .050) were observed in the patients with cancer below the peritoneal reflection.

Conclusions

Laparoscopic lower rectal surgery using the RC with a CF is feasible and provides acceptable surgical and oncological outcomes.

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Zusatzmaterial
Supplementary material 1 (MP4 85649 kb)
Supplementary material 2 (MP4 167634 kb)
Supplementary material 3 (MP4 90629 kb)
Literatur
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