Authors: H Meillat C de Chaisemartin F Poizat E Bories R Fara J R Delpero B Lelong
Publish Date: 2016/12/19
Volume: 21, Issue: 1, Pages: 43-51
Abstract
Surgery for low rectal cancer remains a challenge when a standard laparoscopic approach is used Transanal endoscopic total mesorectal excision TME has been shown to be feasible and to be associated with a low conversion rate Combining the transanal and transabdominal singleport approaches with an abdominal single port implanted in the future stoma and extraction site could allow TME with minimal wound trauma low morbidity and faster recovery The aim of the current study was to assess the short and midterm results of this techniqueDuring the study period 41 patients were recruited Conversion to open surgery was required in only one patient 24 The median operating time was 3585 min range 300–600 min Partial intersphincteric resection was necessary for 15 patients 366 The specimens were mostly extracted via the abdominal access n = 34 without wound complications The mean number of lymph nodes harvested was 127 range 6–24 lymph nodes Specimens were graded as complete n = 31 or nearly complete n = 10 in all of the patients and the circumferential resection margin positivity was 49 Intraoperative morbidity rate was 49 and the 30day morbidity rate was 244 n = 10 Sixty per cent n = 6 of the patients with 30day morbidity were Dindo I–II At a median followup of 29 months overall and diseasefree survival rates were 975 and 805 respectively The stomafree survival rate was 951All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards
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