Laparoscopic ultralow anterior resection versus laparoscopic pull-through with coloanal anastomosis for rectal cancers: a comparative study
Hiranyakas, Art, and Ho, Yik-Hong (2011) Laparoscopic ultralow anterior resection versus laparoscopic pull-through with coloanal anastomosis for rectal cancers: a comparative study. American Journal of Surgery, 202 (3). pp. 291-297.
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Background: Ultralow anterior resection for mid and distal rectal cancers has been reported routinely performed using either a laparoscopic ultralow anterior resection (LAR) or laparoscopic pull-through with coloanal anastomosis (LPT). This study evaluated the postoperative and functional outcomes.
Methods: Between January 2007 and December 2008, 40 consecutive patients had laparoscopic surgery for rectal cancers. The data were prospectively collected.
Results: There were 21 patients (21 men; mean age 61.2 ± 3.2 years standard error of the mean [SEM]) in the LAR group and 19 (16 men; mean age 61.4 ± 2.4 years SEM) in the LPT group. Tumor characteristics, adjuvant therapy given, mean follow-up (overall 33.5 ± 1.4 months SEM), intraoperative time, blood loss, mesorectum quality, conversion rate (LAR n = 2, LPT n = 1), pain score, time for ileostomy to function, subsequent incontinence scores, and complication rates (LAR n = 7, LPT n = 9) were not different between groups, but benign anastomotic strictures were higher after LPT (n = 4, LAR n = 0, P = .042). The latter was associated with chemoradiotherapy (P = .015). There were 2 systemic cancer recurrences both in the LPT group but no local recurrences to date.
Conclusions: The LAR technique may have less risk of anastomotic strictures, particularly with adjuvant therapy. LPT may be considered selectively for a bulky distal rectal tumor in a small pelvis with comparable functional results.
|Item Type:||Article (Refereed Research - C1)|
|Keywords:||rectal cancer, laparoscopic surgery, ultralow anterior resection, pull-through, coloanal anastomosis|
|FoR Codes:||11 MEDICAL AND HEALTH SCIENCES > 1112 Oncology and Carcinogenesis > 111202 Cancer Diagnosis @ 100%|
|SEO Codes:||92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920102 Cancer and Related Disorders @ 100%|
|Deposited On:||13 Mar 2012 15:39|
|Last Modified:||16 May 2013 01:44|
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