Transperineal minimally invasive surgery during laparoscopic abdominoperineal resection for low rectal cancer could improve short-term outcomes: A single-institution retrospective cohort study.

IF 2.1 3区 医学 Q2 SURGERY
Akihiro Kondo, Takuro Fuke, Kensuke Kumamoto, Eisuke Asano, Dongping Feng, Hideki Kobara, Keiichi Okano
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引用次数: 0

Abstract

Purpose: Transperineal minimally invasive surgery (TpMIS) during laparoscopic abdominoperineal resection (APR) is an emerging approach that allows for the precise treatment of lower rectal cancer. However, evidence regarding the efficacy of TpMIS is insufficient. This study evaluated the efficacy of TpMIS during laparoscopic APR for patients with lower rectal cancer.

Methods: Patients who underwent laparoscopic APR with TpMIS (TpMIS group; n = 12) and those who underwent conventional laparoscopic APR for low rectal cancer (conventional group; n = 13) were enrolled consecutively in this retrospective study. Standardized TpMIS was performed at our institution. Patient and tumor characteristics and intraoperative, postoperative, and pathological outcomes were compared between groups. The primary outcome was postoperative perineal wound infection.

Results: No patients in the TpMIS group experienced postoperative perineal wound infection; however, five (38.5%) patients in the conventional group experienced postoperative perineal wound infection (significant difference; p = 0.016). The estimated blood loss (median, 81 mL vs. 463 mL) and incidence of postoperative urinary dysfunction (8.3% vs. 46.1%) were significantly lower in the TpMIS group than in the conventional group. The postoperative hospital stay (median, 13 vs. 20 days) of the TpMIS group was significantly shorter than that of the conventional group. Pathological outcomes did not differ between groups. The positive circumferential resection margin rates of the TpMIS and conventional groups were 8.3% and 15.4%, respectively.

Conclusion: TpMIS during laparoscopic APR was associated with significant improvements in the postoperative outcomes of patients with low rectal cancer.

腹腔镜腹会阴低位直肠癌切除术中经会阴微创手术可改善短期疗效:一项单一机构的回顾性队列研究。
目的:在腹腔镜腹会阴切除术(APR)期间进行经会阴微创手术(TpMIS)是一种新兴的方法,可精确治疗下段直肠癌。然而,有关TpMIS疗效的证据尚不充分。本研究评估了腹腔镜下直肠癌切除术中TpMIS的疗效:这项回顾性研究连续纳入了接受腹腔镜 APR 并使用 TpMIS 的患者(TpMIS 组;n = 12)和接受传统腹腔镜 APR 治疗低位直肠癌的患者(传统组;n = 13)。标准化的 TpMIS 在我院进行。两组患者和肿瘤特征以及术中、术后和病理结果进行了比较。主要结果是术后会阴伤口感染:结果:TpMIS组没有患者发生术后会阴伤口感染;而传统组有5名(38.5%)患者发生术后会阴伤口感染(差异显著;P = 0.016)。TpMIS 组的估计失血量(中位数,81 毫升对 463 毫升)和术后排尿功能障碍发生率(8.3% 对 46.1%)明显低于传统组。TpMIS 组的术后住院时间(中位 13 天对 20 天)明显短于传统组。两组的病理结果无差异。TpMIS组和传统组的圆周切除边缘阳性率分别为8.3%和15.4%:结论:腹腔镜 APR 期间的 TpMIS 可显著改善低位直肠癌患者的术后效果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.30
自引率
8.70%
发文量
342
审稿时长
4-8 weeks
期刊介绍: Langenbeck''s Archives of Surgery aims to publish the best results in the field of clinical surgery and basic surgical research. The main focus is on providing the highest level of clinical research and clinically relevant basic research. The journal, published exclusively in English, will provide an international discussion forum for the controlled results of clinical surgery. The majority of published contributions will be original articles reporting on clinical data from general and visceral surgery, while endocrine surgery will also be covered. Papers on basic surgical principles from the fields of traumatology, vascular and thoracic surgery are also welcome. Evidence-based medicine is an important criterion for the acceptance of papers.
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