title: Outcomes of laparoscopic Miles' operation in very low rectal adenocarcinoma. Analysis of 32 cases.
abstract: OBJECTIVE
  Minivasive techniques for excision of low rectal tumours have spread worldwide with good results, but their employment is still under discussion. The purpose of this study is to assess short term results and survival of laparoscopic abdominoperineal resection (LAPR) in very low rectal cancers.
  
  
  METHODS
  The charts of 32 patients undergoing LAPR for very low rectal adenocarcinoma (0-2cm from dentata line) were reviewed retrospectively. Outcomes were evaluated considering surgical procedure, short and long-term results and survival.
  
  
  RESULTS
  A thorough LAPR was performed in 31 patients and conversion to laparotomy was required in 1 patient. Mean operating time was 244min. The length of hospital stay (LOS) was 13,3days. The mean number of nodes collected was 12 and the distal margin was 3,6cm on average. There was 1 post-operative death. In the follow up no pelvic recurrence was observed, while metachronous metastases were observed in 5 patients and peritoneal carcinosis in 2 patients. No port site metastasis was registered. Cumulative 5year survival probability was 0,50.
  
  
  CONCLUSIONS
  The outcomes of this study suggest that LAPR in very low rectal cancer is a reliable procedure, operating time and LOS were acceptable. Oncologic principles were respected: length of specimen, distal margin and number of nodes retrieved were quite acceptable. Pelvic recurrence frequency was nil. Long term results were comparable with those of other series.
authors.affiliation: Surgery Department, General and Videolaparoscopic Surgery, Hospital Niguarda, Piazza Ospedale Maggiore 3, 20162 Milan, Lombardy, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pugliese
authors.forename: S
authors.initials: S
authors.lastname: Di Lernia
authors.forename: F
authors.initials: F
authors.lastname: Sansonna
authors.forename: G C
authors.initials: GC
authors.lastname: Ferrari
authors.forename: D
authors.initials: D
authors.lastname: Maggioni
authors.forename: I
authors.initials: I
authors.lastname: Scandroglio
authors.forename: A
authors.initials: A
authors.lastname: Costanzi
authors.forename: C
authors.initials: C
authors.lastname: Magistro
authors.forename: S
authors.initials: S
authors.lastname: De Carli
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome