[Total laparoscopic sigmoid and rectal surgery combined with transanal endoscopic microsurgery].
OBJECTIVE
To investigate the feasibility and short-term outcomes of total laparoscopic sigmoid and rectal surgery combined with transanal endoscopic microsurgery(TEM).


METHODS
The clinical data of 26 patients with colorectal carcinoma treated by total laparoscopic surgery with TEM between May 2010 and May 2011 in the Shanghai Ruijin Hospital were retrospectively analyzed.


RESULTS
All the 26 operations were successfully accomplished laparoscopically. There was no conversion to open procedure. No diverting ileostomy was made. The mean operative time was (151.6±25.9) min. The mean blood loss was (200.2±114.7) ml. The mean time to first flatus was (2.0±0.5) d. The mean tumor size was (3.0±0.7) cm and all resection margins were negative. The mean number of lymph nodes harvested was (12.9±2.2). Six patients developed postoperative anastomotic leakage, all of who had tumors in the lower rectum. There were no ureteral injury, intestinal obstruction, or pulmonary infection.


CONCLUSIONS
Total laparoscopic sigmoid and rectal surgery combined with TEM is a safe and feasible minimally invasive surgery. It is an improvement by combining laparoscopic skills with the concept of natural orifice transluminal endoscopic surgery.
Department of Surgery, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Yi
Y
Han
Yong-gang
YG
He
Mou-bin
MB
Lin
Hao-bo
HB
Zhang
Xing-sheng
XS
Lu
Ke-zi
KZ
Lv
Zhi-li
ZL
Hua
Ya-jie
YJ
Zhang
Lu
L
Yin
D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D015179:Colorectal Neoplasms / Q000601:surgery*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome