title: Laparoscopic Low Anterior Resection of the Rectum with Transanal Prolapsing Specimen Extraction: Early Experience with 23 Patients.
abstract: OBJECTIVE
  For laparoscopic low anterior resection of the rectum, a small additional incision is needed to extract the specimen. We describe an adjustment technique, which inserted the anvil and extracted the specimen through transanal pathway.
  
  
  METHODS
  Between July 2010 and July 2012, 23 patients underwent laparoscopic rectal surgery with transanal anvil insertion and transanal prolapsing specimen extraction. All perioperative data and short-term outcomes were recorded in a database.
  
  
  RESULTS
  The mean patient age was 61.3 years (range 47-68 years). Of the 23 patients, 17 underwent resection for rectal carcinoma and 6 had tubulovillous adenomas. No intraoperative complications occurred. The mean operative time was 137 minutes (range 118-170 minutes). The distal margins, circumferential resection margins, and lymph node dissections were oncologically adequate for all malignancies. One patient experienced anastomotic leakage (4.3%), treated conservatively. One male patient with benign prostatic hyperplasia suffered from postoperative urinary retention. The average postoperative hospital stay was 11.3 days (range 7-21 days). No patients experienced anal dysfunction. At a median follow-up of 26 months, there were no tumor recurrences.
  
  
  CONCLUSIONS
  The technique of transanal prolapsing specimen extraction for laparoscopic low anterior resection of the rectum is feasible and safe for selected patients.
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Hong
authors: H
authors: Zhang
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Jin-Chun
authors: JC
authors: Cong
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Yun-Zhi
authors: YZ
authors: Ling
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Ming-Ming
authors: MM
authors: Cui
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Fang-Yuan
authors: FY
authors: Zhang
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Yong
authors: Y
authors: Feng
authors: Department of Colorectal Surgery, Shengjing Hospital, China Medical University , Shenyang, China .
authors: Chun-Sheng
authors: CS
authors: Chen
mesh_terms: D000368:Aged; D001003:Anal Canal; D003082:Colectomy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D061646:Operative Time; D012004:Rectal Neoplasms / Q000601:surgery*; D012007:Rectum / Q000601:surgery*; D016896:Treatment Outcome