title: [Clinical study of laparoscopic sphincter-preserving proctectomy for low rectal cancer using transanal telescopic anastomosis].
abstract: OBJECTIVE
  To investigate the safety, feasibility and clinical outcomes of laparoscopic sphincter-preserving proctectomy for low rectal cancer using transanal telescopic anastomosis.
  
  
  METHODS
  Five patients underwent laparoscopic sphincter-preserving proctectomy for low rectal cancer using transanal telescopic anastomosis between March 2011 and April 2011 at the General Hospital of Beijing Military Command. After lymph node dissection around the mesentery using harmonic scalpel, the root of the inferior mesenteric vessel was ligated and transected. Rectal dissection was further carried out until 5 cm distal to the lower margin of the tumor. A circumferential incision was made 1.0 cm above the dentate line using 5 support stitches for exposure. The submucous layer was striped upward to the level of the levator ani, and rectum was transected. Rectum and sigmoid colon were extracted transanally and removed. Finally, colonanal anastomosis was made using telescopic technique.
  
  
  RESULTS
  Five patients underwent the procedure successfully. The mean operative time was 178 minutes. The mean intraoperative blood loss was 76 ml. The mean lymph nodes retrieval was 14. Bowel function recovered after a mean of 3 days. There were no postoperative complications. No obvious scars were seen in the abdomen or the anus. The mean hospital stay was 12 days. After one year of follow-up, all the patients survived cancer-free.
  
  
  CONCLUSIONS
  Laparoscopic anterior resection with sphincter preservation by transanal telescopic anastomosis for low rectal cancer is feasible and safe. Abdominal incision is minimal. However, the long-term outcomes require further investigation.
authors.affiliation: Department of General Surgery, General Hospital of Beijing Military Command, Beijing 100700, China. lsybz@126.com
authors.forename: Shi-yong
authors.initials: SY
authors.lastname: Li
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.forename: Fu-yi
authors.initials: FY
authors.lastname: Zuo
authors.forename: Xiao-jun
authors.initials: XJ
authors.lastname: Wei
authors.forename: Qiang
authors.initials: Q
authors.lastname: Yuan
authors.forename: Jun-feng
authors.initials: JF
authors.lastname: DU
mesh_terms: D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000601:surgery*