Laparoscopic Rectal Cancer Surgery : Early Experience at Lampang Hospital
Article Sidebar
Main Article Content
บทคัดย่อ
Background: Laparoscopic rectal cancer surgery is a form of minimally invasive surgery that has evolved over time. Laparoscopic rectal cancer surgery involves several challenges, including an even longer learning curve when compared to laparoscopic colon cancer surgery.
Objective: To demonstrate the short-term results of laparoscopic rectal cancer surgery and share early experiences with this technique.
Material and methods: Nine patients with rectal cancer underwent laparoscopic rectal cancer surgery between July 2022 and February 2023 by a single surgeon at Lampang Hospital. All patients underwent preoperative computerized tomography of the chest and abdomen, and pelvic magnetic resonance imaging. Four patients with lower rectal lesions received neoadjuvant concurrent chemoradiotherapy (CCRT) before surgery, which was performed within 8–12 weeks after the last date of CCRT.
Results: The patients included six women and three men, with a mean age of 61.0 (SD 9.1) years (range, 44–70). Among them, four had lesions located in the rectosigmoid junction, one in the middle rectum, and four in the lower rectum. The operative time ranged from 210 to 480 minutes (mean 340, SD 95), and the intraoperative blood loss ranged from 50 to 500 mL (mean 161, SD 143). The length of stay ranged from 6 to 8 days (mean 7.1, SD 0.7). There were no perioperative or postoperative complications. Pathological reports indicated adequate inclusion of the distal rectal margin, circumferential resection margin, and lymph nodes.
Conclusion: Laparoscopic rectal cancer surgery utilizing the medial approach technique provides numerous short-term benefits. The inclusion of a supervisory surgeon or a structured training program can aid in achieving a steeper learning curve in this technique.
Article Details
อนุญาตภายใต้เงื่อนไข Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
เอกสารอ้างอิง
Semm K. Endoscopic appendectomy. Endoscopy. 1983;15(02):59–64.
Gollan JL, Bulkley GB, Diehl AM, Elashoff JD, Federle MP, Henderson JM, et al. Gallstones and laparoscopic cholecystectomy. JAMA. 1993;269(8):1018–24.
Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopiccolectomy). SurgLaparoscEndosc. 1991;1(3):144–50.
Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery--the clue topelvic recurrence?. Br J Surg. 1982;69(10):613–6.
Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet.1986;1(8496):1479–82.
Heald RJ. The ‘Holy Plane’ of rectal surgery. J R Soc Med. 1988;81(9):503–8.
Steele RJ. Anterior resection with total mesorectal excision. J R Coll Surg Edinb.1999;44(1):40–5.
Kolarsick PA, Sacchi M, Spinelli A, Wexner SD. Minimizing the impact of colorectal surgery in the older patient: The role of minimally invasive surgery in the geriatric population. Eur J Surg Oncol. 2020;46(3):333–7.
Aly EH. Laparoscopic colorectal surgery: summary of the current evidence. Ann R Coll Surg Engl. 2009;91(7):541–4.
You YN, Hardiman KM, Bafford A, Poylin V, Francone TD, Davis K, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for the management of rectal cancer. Dis Colon Rectum. 2020;63(9):1191–222.
Wexner SD, Fleshman JW. Colon and rectal surgery abdominal operations. Philadelphia: Lippincott Williams & Wilkins; 2012.
Steele SR, Hull TL, Hyman N, Maykel JA, Read TE, Whitlow CB. The ASCRS Textbook of colon and rectal surgery. 4th ed. New York : Springer;2022
Bonjer HJ, Deijen CL, Abis GA, Cuesta MA, van der Pas MH, de Lange-de Klerk ES, et al. A randomized trial of laparoscopic versus open surgery for rectal cancer. N Engl J Med. 2015;372(14):1324–32.
Kang SB, Park JW, Jeong SY, Nam BH, Choi HS, Kim DW, et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol. 2010;11(7):637–45.
Fleshman J, Branda M, Sargent DJ, Boller AM, George V, Abbas M, et al. Effect of laparoscopic -assisted resection vs open resection of stage II or III rectal cancer on pathologic outcomes: The ACOSOG Z6051 randomized clinical trial. JAMA. 2015;314(13):1346–55.
Stevenson AR, Solomon MJ, Lumley JW, Hewett P, Clouston AD, Gebski VJ, et al.Efect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the ALaCaRT randomized clinical trial. JAMA. 2015;314(13):1356–63
Monson JR, Weiser MR, Buie WD, Chang GJ, Rafferty JF, Buie WD, et al. Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum. 2013;56(5):535–50.
