Total laparoscopic sigmoid and rectal surgery in combination with transanal endoscopic microsurgery: a preliminary evaluation in China.
BACKGROUND
This study was designed to evaluate the feasibility and safety of total laparoscopic sigmoid and rectal surgery without abdominal incision in combination with transanal endoscopic microsurgery (TEM).


METHODS
From May 2010 to October 2011, 34 patients with colon and rectal tumors were treated by total laparoscopic surgery without abdominal incision, and the clinical data of these patients were reviewed.


RESULTS
All operations could be successfully accomplished without conversion to open surgery. No diverting ileostomy was created. The average operative time was 151.60 (range, 125-185) minutes. The average blood loss was 200.20 (range, 55-450) ml. All resection margins were negative. Six patients developed postoperative anastomotic leakage. There were no reports of other complications in all patients.


CONCLUSIONS
This preliminary study indicated that total laparoscopic sigmoid and rectal surgery in combination with TEM was a safe, feasible, and minimally invasive technique. This advanced surgical technique was developed by combining laparoscopy with the concept of natural orifice transluminal endoscopic surgery.
Department of General Surgery, Ruijin Hospital Affiliated Shanghai Jiaotong University School of Medicine, No.197, Ruijin No 2 road, Shanghai, China. mystephon@hotmail.com
Yi
Y
Han
Yong-Gang
YG
He
Hao-Bo
HB
Zhang
Ke-Zhi
KZ
Lv
Ya-Jie
YJ
Zhang
Mou-Bin
MB
Lin
Lu
L
Yin
D000328:Adult; D000368:Aged; D001003:Anal Canal; D002681:China; D012809:Colon, Sigmoid / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D012007:Rectum / Q000601:surgery*