caa a22 4500 475780922 CHVBK 20180406123644.0 cr unu---uuuuu 170329e20000801xx s 000 0 eng 10.1007/s004640020085 doi (NATIONALLICENCE)springer-10.1007/s004640020085 Laparoscopically assisted transsacral resection of rectal cancer with primary anastomosis [Elektronische Daten] A preliminary review [D. Weaver, S. Eachempati] Background: The management of rectal cancer has been changing to include more sphincter-sparing procedures. We report our initial experience with a new technique incorporating laparoscopy and a transsacral approach for low or midlevel rectal cancer. Here, we tried to determine whether this sphincter-sparing method could produce acceptable morbidity and recurrence rates. Methods: Patients with rectal cancer 4 to 8 cm from the dentate line underwent laparoscopically-assisted transsacral resection (LTR) with primary anastomosis. With this technique, the rectosigmoid is mobilized via laparoscopy while the patient is in the supine position. Next, the patient is placed in the prone jackknife position, and a segment of rectum is resected by a transsacral approach. Age, estimated blood loss, length of time in the operating room, length of stay, and postoperative complications were noted. Aspects of the tumor pathology regarding stage, lymph nodes, tumor size, and presence of tumor at resection margins also were recorded. Results: A total of 13 patients, ages 26 to 70 years (mean, 52.5 years), underwent the procedure. No perioperative deaths occurred. The mean hospital stay was 9.6 days. The average size of the rectal lesion was 4.3 cm in the largest dimension. The average specimen contained 11.5 total, and 2.0 metastatic lymph nodes. Postoperative complications included two anastomotic breakdowns and two other wound complications. Late follow-up evaluation ranged from 10 to 30 months, with 11 of 13 patients alive (85% survival). Two local recurrences and three distant recurrences were noted at long-term follow-up assessment. Conclusions: In selected patients with low or midlevel rectal cancer, LTR may be a viable option. Further experience is necessary to define its oncologic efficacy and whether routine temporary diverting colostomy is indicated. Springer-Verlag, 2000 Cancer nationallicence Colorectal nationallicence Kraske nationallicence Laparoscopic nationallicence Neoplasm nationallicence Rectal nationallicence Resection nationallicence Sphincter-sparing nationallicence Transsacral nationallicence Weaver D. Wayne State University School of Medicine, 48201, Detroit, MI, USA aut Eachempati S. Weill Medical College of Cornell University, 10021, New York, NY, USA aut Surgical Endoscopy Springer-Verlag 14/8(2000-08-01), 703-707 0930-2794 14:8<703 2000 14 464 https://doi.org/10.1007/s004640020085 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640020085 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Weaver D. Wayne State University School of Medicine, 48201, Detroit, MI, USA aut NATIONALLICENCE 700 1- Eachempati S. Weill Medical College of Cornell University, 10021, New York, NY, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/8(2000-08-01), 703-707 0930-2794 14:8<703 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer