Laparoscopic oncologic total abdominal colectomy with intraperitoneal stapled anastomosis in a canine model.
The purpose of this study was to evaluate the feasibility of performing an oncologic type of colectomy using laparoscopic techniques with intraperitoneal stapled ileorectal anastomosis in a canine model. In 21 dogs, laparoscopic oncologic colectomy was carried out using dissection with a contact Nd:YAG laser. The right, middle colic, and inferior mesenteric arteries were transected close to their origins, and all adjacent mesenteric lymph nodes were removed. Ileorectal anastomosis was performed using a circular end-to-end stapler especially designed for laparoscopic surgery. Two weeks after surgery, all animals were killed. The number of remaining mesenteric lymph nodes, bursting pressure of ileorectal anastomosis, and postoperative morbidity were evaluated. No major intraoperative complications were recorded. One dog died postoperatively from an anastomotic leak. All dogs passed feces in the first 24 postoperative hours. Median operative time was 145 min (90-240 min). The number of remaining colonic mesenteric lymph nodes was 0, and median anastomotic bursting pressure was 325 mm Hg (183-415 mm Hg). The median distance from ileocolic anastomosis to anal verge was 8.5 cm (6.0-11.0 cm). Laparoscopic oncologic colectomy with wide mesenteric clearance of lymph nodes and intraperitoneal stapled ileorectal anastomosis is feasible and safe in a canine model.
Böhm
B
B
Department of Colorectal Surgery, Cleveland Clinic Foundation, OH.
Milsom
J W
JW
Kitago
K
K
Brand
M
M
Fazio
V W
VW
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000818:Animals; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000033:anatomy & histology / Q000098:blood supply / Q000503:physiopathology / Q000601:surgery; D003110:Colonic Neoplasms / Q000601:surgery*; D004285:Dogs; D005240:Feasibility Studies; D005243:Feces; D005260:Female; D007082:Ileum / Q000503:physiopathology / Q000601:surgery; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D053685:Laser Therapy; D008198:Lymph Nodes / Q000033:anatomy & histology / Q000601:surgery; D008297:Male; D008638:Mesenteric Arteries / Q000033:anatomy & histology / Q000601:surgery; D008643:Mesentery / Q000033:anatomy & histology / Q000601:surgery; D011312:Pressure; D012007:Rectum / Q000503:physiopathology / Q000601:surgery; D013528:Surgical Staplers; D017792:Surgical Stapling / Q000009:adverse effects