[Experience of laparoscopic salvage surgery for locally recurrent rectal cancer].
OBJECTIVE
To investigate the feasibility of the laparoscopic salvage surgery for locally recurrent rectal cancer.


METHODS
Seven cases with recurrent rectal carcinoma treated by laparoscopic salvage surgery from February 2004 to July 2005 were retrospectively analyzed. Among them, four were males and 3 females, and the median age was 60 years (range 37-74). Three cases of recurrence were after conventional anterior resection, 2 after laparoscopic-assist anterior resection, 1 after laparoscopic-assist Parks' procedure, and 1 with pars sacral fistula after per-sacral-local resection for three times. Image examination (CT scanning) was taken preoperatively to evaluate the locally recurrence and exclude the distant metastases. The laparoscopic-assist procedure with or without a hand-assist technique was used in this study.


RESULTS
Six cases with the recurrent lesion of central type were treated by salvage surgical procedure as follows: 3 laparoscopic-assist anterior resection, 1 laparoscopic-assist abdominoperineal resection, 1 laparoscopic-assist posterior exenteration, and 1 laparoscopic-assist proctocolectomy with a terminal ileum stoma. All of them were R0 resection confirmed by postoperative pathological examination. The other one with the lesion of combination type was treated with the procedure of laparoscopic-assist sigmoid colostomy. A hand-assist technique was used in 2 cases. The mean operation time, bleeding and hospital day was (211 +/- 13) min, (200 +/- 91) ml, and (15 +/- 10) d, respectively. No conversion and complication occurred.


CONCLUSIONS
Laparoscopic salvage surgery for locally recurrent rectal cancer is safe and feasible when taken by experienced laparoscopic colorectal surgeon to the cases with the recurrent lesion of central type.
Lu
Ai-guo
AG
Department of General Surgery, Ruijin Hospital, Medical College of Shanghai Jiaotong University, Shanghai Minimally Invasive Surgery Center, Shanghai 200025, China.
Wang
Ming-liang
ML
Hu
Wei-guo
WG
Li
Jian-wen
JW
Zang
Lu
L
Mao
Zhi-hai
ZH
Dong
Feng
F
Feng
Bo
B
Ma
Jun-jun
JJ
Zong
Ya-ping
YP
Zheng
Min-hua
MH
D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012004:Rectal Neoplasms / Q000601:surgery*; D012086:Reoperation; D016879:Salvage Therapy; D016896:Treatment Outcome