Laparoscopic resection for middle and low rectal cancer.
OBJECTIVE
The purpose of this study was to evaluate the technical feasibility, safety and oncological outcomes of laparoscopic resection for middle and low rectal cancers.


METHODS
From January 2004 to December 2011, review of prospectively collected database revealed a series of 97 laparoscopic resections for middle and low rectal cancer within 10 cm from the anal verge. Five patients with multiple primary cancers were excluded. Operation time, intra-operative blood loss, surgical complications, duration of hospital stay, retrieved lymph nodes, tumour, node, metastasis (TNM) stage and recurrence were retrospectively analysed.


RESULTS
Tumours were located within 5 cm of the anal verge in 28 patients (30.4%) and from 5 cm to 10 cm in 64 patients (69.6%). Abdominoperineal resection was performed in 12 patients (13%), and conversion to open surgery was necessary in four patients (4.3%). The mean operation time was 199.7 min (range 105-450 min) and the mean intra-operative blood loss was 169.9 mL (range 20-800 mL). The mean hospital stay was 11.8 days (range 5-45 days) and a mean of 12.2 lymph nodes were retrieved. The incidence of surgical complications was 11.9%, including anastomosis site leakage in five patients (5.4%). There were no mortalities resulting from laparoscopic surgery. The median follow-up period was 28.4 months (range 7-85 months). Recurrence occurred in eight patients (8.7%).


CONCLUSIONS
Laparoscopic resection can be applied for middle and low rectal cancers with acceptable surgical and oncological outcomes.
Department of Surgery, Kosin University College of Medicine, Busan, South Korea.
Kwang-Kuk
KK
Park
Department of Surgery, Kosin University College of Medicine, Busan, South Korea.
Seung-Hyun
SH
Lee
Department of Surgery, Kosin University College of Medicine, Busan, South Korea.
Sung-Uhn
SU
Baek
Department of Surgery, Kosin University College of Medicine, Busan, South Korea.
Byung-Kwon
BK
Ahn
Anastomotic leakage; laparoscopic surgery; rectal cancer; recurrence