Short-Term and 3-Year Oncological Outcomes in Laparoscopic-Assisted Trans-Anal Pelvic Exenteration With Preserving Anal Sphincter for Locally Advanced Rectal Cancer

IF 0.9 Q4 ORTHOPEDICS
Takashi Nonaka, Tetsuro Tominaga, Toshio Shiraishi, Shintaro Hashimoto, Keisuke Noda, Terumitsu Sawai, Keitaro Matsumoto
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引用次数: 0

Abstract

Purpose

Pelvic exenteration (PE) for rectal cancer is highly invasive. The trans-anal approach (Ta-PE) offers a minimally invasive alternative. This study evaluates the perioperative and long-term outcomes of laparoscopic-assisted Ta-PE.

Methods

A retrospective analysis was conducted on 17 patients who underwent laparoscopic-assisted Ta-PE with preserving anal sphincter between April 2018 and September 2024. Perioperative and oncological outcomes, including operative time, complications, hospital stay, and survival rates, were assessed.

Results

The median age was 64 years (nine men, eight women). Total-PE was performed in 11 patients (64.7%), and posterior-PE in 6 (35.3%). Urinary diversion was required in 13 (76.5%). Mean operative time was 464 min, with no conversions. Clavien–Dindo Grade III–IV complications occurred in four cases (23.5%), including pelvic abscess (n = 3) and postoperative bleeding (n = 1). No reoperations or 90-day mortality were observed. The median hospital stay was 21 days. Three-year overall survival, disease-free survival, and local control rates were 69.9%, 45.4%, and 93.8%, respectively.

Conclusion

Laparoscopic-assisted Ta-PE is a promising minimally invasive option for locally advanced rectal cancer, with favorable perioperative outcomes and effective local disease control. Larger studies are needed to confirm these findings and refine patient selection.

腹腔镜辅助下经肛门盆腔切除保留肛门括约肌治疗局部晚期直肠癌的短期和3年肿瘤预后
目的盆腔切除(PE)治疗直肠癌具有高度侵袭性。经肛门入路(Ta-PE)提供了一种微创的替代方法。本研究评估腹腔镜辅助Ta-PE的围手术期和远期疗效。方法回顾性分析2018年4月至2024年9月17例腹腔镜下Ta-PE保留肛门括约肌的患者。评估围手术期和肿瘤预后,包括手术时间、并发症、住院时间和生存率。结果中位年龄64岁(男9例,女8例)。11例(64.7%)患者行全pe, 6例(35.3%)患者行后pe。13例(76.5%)患者需要导尿。平均手术时间为464分钟,无转阴。Clavien-Dindo III-IV级并发症4例(23.5%),包括盆腔脓肿(n = 3)和术后出血(n = 1)。无再手术及90天死亡率。平均住院时间为21天。三年总生存率、无病生存率和局部控制率分别为69.9%、45.4%和93.8%。结论腹腔镜辅助Ta-PE治疗局部晚期直肠癌是一种很有前景的微创治疗方法,围手术期预后良好,局部疾病控制有效。需要更大规模的研究来证实这些发现并改进患者选择。
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
2.00
自引率
10.00%
发文量
129
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