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Surgical Endoscopy
Erschienen in:

12.07.2021 | Dynamic Manuscript

Transperineal minimally invasive abdominoperineal resection for low rectal cancer: standardized technique and clinical outcomes

verfasst von: Takeru Matsuda, Kimihiro Yamashita, Hiroshi Hasegawa, Gosuke Takiguchi, Naoki Urakawa, Masashi Yamamoto, Shingo Kanaji, Taro Oshikiri, Tetsu Nakamura, Satoshi Suzuki, Yoshihiro Kakeji

Erschienen in: Surgical Endoscopy | Ausgabe 12/2021

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Abstract

Background

Despite the increasing utilization of transanal total mesorectal excision as a promising approach for low rectal cancer, the feasibility and safety of transperineal minimally invasive abdominoperineal resection (tp-APR) remain unclear.

Methods

In total, 25 patients who underwent tp-APR between April 2017 and May 2020 (tp-APR group) and 27 patients who underwent conventional laparoscopic APR between May 2009 and September 2016 (lap-APR group) for low rectal cancer were enrolled in this retrospective study. Clinical outcomes were compared between the groups before and after propensity score matching. The primary outcome was the incidence of the overall postoperative complications with Clavien–Dindo grade II or above. Standardized technique of tp-APR was also demonstrated.

Results

On comparison, operative time, intraoperative blood loss, and overall postoperative complications with Clavien–Dindo grade II or above were significantly less in the tp-APR group both before and after propensity score matching. The rates of urinary disturbance and perineal wound infection were significantly less in the tp-APR group after matching. Further, postoperative hospital stay was significantly shorter in the tp-APR group both before and after matching. However, pathological outcomes did not differ between the groups before and after matching. There has been no local recurrence in the tp-APR group with a median follow-up period of 18 months.

Conclusion

Standardized tp-APR for low rectal cancer is feasible and seems superior to conventional laparoscopic APR in terms of short-term outcomes. Further larger-scale studies with a longer follow-up period are required to evaluate oncological outcomes.
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Metadaten
Titel
Transperineal minimally invasive abdominoperineal resection for low rectal cancer: standardized technique and clinical outcomes
verfasst von
Takeru Matsuda
Kimihiro Yamashita
Hiroshi Hasegawa
Gosuke Takiguchi
Naoki Urakawa
Masashi Yamamoto
Shingo Kanaji
Taro Oshikiri
Tetsu Nakamura
Satoshi Suzuki
Yoshihiro Kakeji
Publikationsdatum
12.07.2021
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 12/2021
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-021-08633-5

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