DOI QR코드

DOI QR Code

Outcomes of Laparoscopic Abdominoperineal Resection in Low Rectal Cancer Using Different Pelvic Drainages

  • Chen, Yu-Sheng (General Surgery Department, Zhongshan Hospital, Fudan University) ;
  • Bo, Xiao-Bo (General Surgery Department, Zhongshan Hospital, Fudan University) ;
  • Gu, Da-Yong (General Surgery Department, Zhongshan Hospital, Fudan University) ;
  • Gao, Wei-Dong (General Surgery Department, Zhongshan Hospital, Fudan University) ;
  • Sheng, Wei-Zhong (General Surgery Department, Zhongshan Hospital, Fudan University) ;
  • Zhang, Bo (General Surgery Department, Zhongshan Hospital, Fudan University)
  • Published : 2015.02.04

Abstract

Background: The aim of this study was to establish the feasibility and efficiency of different pelvic drainage routes after laparoscopic abdominoperineal resection (LAPR) for rectal cancer by assessing short-term outcomes. Materials and Methods: Clinicopathological data of 76 patients undergoing LAPR for very low rectal cancer were reviewed retrospectively between June 2005 and June 2014. Outcomes were evaluated considering short-term results. Results: Of 76 relevant patients at our institution in the period of study, trans-perineal drainage of the pelvic cavity was performed in 17 cases. Compared with the trans-perineal group, the length of hospital stay was shorter in the trans-abdominal group, while the duration of drainage and the infection rates of the perineal wounds between two groups showed no significant differences. Conclusions: The outcomes of this study suggest that trans-abdominal drainage of pelvic cavity is a reliable and feasible procedure, the duration of drainage, infection rates and the healing rates of the perineal wounds being acceptable. Trans-abdominal drainage has a more satisfactory effect after laparoscopic abdominoperineal resection for rectal carcinoma.

Keywords

Rectal cancer;laparoscopic abdominoperineal resection;pelvic drainage

References

  1. Gezen C, Altuntas YE, Kement M, et al (2012). Laparoscopic and conventional resections for low rectal cancers: a retrospective analysis on perioperative outcomes, sphincter preservation, and oncological results. J Laparoendosc Adv Surg Tech A, 22, 625-30. https://doi.org/10.1089/lap.2011.0479
  2. Gong JP, Yang L, Huang XE, et al (2014). Outcomes based on risk assessment of anastomotic leakage after rectal cancer surgery. Asian Pac J Cancer Prev, 15, 707-12. https://doi.org/10.7314/APJCP.2014.15.2.707
  3. Green BL, Marshall HC, Collinson F, et al (2013). Long-term follow-up of the medical research council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg, 100, 75-82. https://doi.org/10.1002/bjs.8945
  4. Guillou PJ, Quirke P, Thorpe H, et al (2005). Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet, 365, 1718-26. https://doi.org/10.1016/S0140-6736(05)66545-2
  5. Heald RJ, Husband EM, Ryall RD(1982). The mesorectum in rectal cancer surgery-the clue to pelvic recurrence? Br J Surg, 69, 613-6. https://doi.org/10.1002/bjs.1800691019
  6. Jatzko GR, Lisborg PH, Wette VM (1996). Extraperitonealization of the anastomosis and sacral drain in restorative surgery for rectal carcinoma: a safety mechanism in the absence of a covering stoma. Surg Today, 26, 591-6. https://doi.org/10.1007/BF00311662
  7. Jayne DG, Guillou P J, Thorpe H, et al (2007). Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol, 25, 3061-8. https://doi.org/10.1200/JCO.2006.09.7758
  8. Kellokumpu I, Vironen J, Kairaluoma M, et al(2012). Quality of surgical care, local recurrence, and survival in patients with low- and midrectal cancers following multimodal therapy. Int J Colorectal Dis, 27, 111-20. https://doi.org/10.1007/s00384-011-1322-5
  9. Law WL, Lee YM, Choi HK, et al (2007). Impact of laparoscopic resection for colorectal cancer on operative outcomes and survival. Ann Surg, 245, 1-7. https://doi.org/10.1097/01.sla.0000218170.41992.23
  10. MacFarlane JK, Ryall RD, Heald RJ (1993). Mesorectal excision for rectal cancer. Lancet, 341, 457-60. https://doi.org/10.1016/0140-6736(93)90207-W
  11. Merad F, Hay JM, Fingerhut A, et al (1999). Is prophylactic pelvic drainage useful after elective rectal or anal anastomosis? A multicenter controlled randomized trial. French Association for Surgical Research. Surgery, 125, 529-35. https://doi.org/10.1016/S0039-6060(99)70205-9
  12. Murrell ZA, Dixon MR, Vargas H, et al (2005).Contemporary indications for and early outcomes of abdominoperineal resection. Am Surg, 71, 837-40.
  13. Schiphorst AH, Doeksen A, Hamaker ME, et al (2014). Shortterm follow-up after laparoscopic versus conventional total mesorectal excision for low rectal cancer in a large teaching hospital. Int J Colorectal Dis, 29, 117-25. https://doi.org/10.1007/s00384-013-1768-8
  14. Simorov A, Reynoso JF, Dolghi O, et al (2011). Comparison of perioperative outcomes in patients undergoing laparoscopic versus open abdominoperineal resection. Am J Surg, 202, 666-70, 670-2. https://doi.org/10.1016/j.amjsurg.2011.06.029
  15. Van der Pas MH, Haglind E, Cuesta MA, et al(2013). Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol, 14, 210-8. https://doi.org/10.1016/S1470-2045(13)70016-0
  16. Veldkamp R, Kuhry E, Hop WC, et al (2005). Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol, 6, 477-84. https://doi.org/10.1016/S1470-2045(05)70221-7
  17. Zhang FW, Zhou ZY, Wang HL, et al(2014). Laparoscopic versus open surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials. Asian Pac J Cancer Prev, 15, 9985-96 https://doi.org/10.7314/APJCP.2014.15.22.9985