[Laparoscopic cylindrical abdominoperineal resection with transabdominal approach for lower rectal cancer].
OBJECTIVE
To evaluate the safety and feasibility of laparoscopic cylindrical abdominoperineal resection.


METHODS
Six patients with rectal adenocarcinoma within 3 cm above the anal verge underwent laparoscopic cylindrical abdominoperineal resection. Transabdominal levator transaction was performed laparoscopically, with no position change during the perineal operation. Pelvic reconstruction was achieved using human acellular dermal matrix mesh in 3 patients.


RESULTS
All the procedures were successfully performed without any intraoperative complications, laparoscopy-associated complications, or conversion to the open approach. The mean operation time was 186.7 minutes and intraoperative blood loss was 101.7 ml. All the specimens had a cylindrical shape with levator muscles attached to the mesorectum and circumferential margins were all negative. No adverse incidence followed the pelvic reconstruction using human acellular dermal matrix mesh.


CONCLUSIONS
Laparoscopic transabdominal transection of the levator muscles without position change and pelvic floor reconstruction with human acellular dermal matrix mesh is feasible. This procedure simplifies cylindrical abdominoperineal resection which is aggressively invasive and technically complicated. The oncologic outcomes are acceptable and complications are less.
Department of Colorectal Surgery, Fujian Medical University, Fuzhou, China. cp3169@163.com
Pan
P
Chi
Zhi-fen
ZF
Chen
Hui-ming
HM
Lin
Xing-rong
XR
Lu
Ying
Y
Huang
D000005:Abdomen / Q000601:surgery; D000368:Aged; D001003:Anal Canal / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000601:surgery; D010502:Perineum / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome