A modified technique of transanal specimen extraction in laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon carcinoma

doi:10.3877/cma.j.issn.1674-0793.2016.04.008

Abstract

Abstract:

Objective

To investigate the feasibility and safety of a modified technique of transanal specimen extraction in laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon cancer.

Methods

From January 2008 to January 2014, forty-eight patients suffered from lower sigmoid colon or upper rectal cancer underwent laparoscopic anterior rectal resection with specimen extracted by a modified transanal technique. As a control, 168 patients underwent laparoscopic anterior rectal resection with specimen extracted via abdominal incision.

Results

There was no significant difference in mean operative time, mean blood loss and mean time of anal flatus between the two groups. However, there were significant differences in mean postoperative Visual Analogue Score, mean postoperative hospital stay between the two groups (P<0.05). Furthermore, there was no significant difference in the overall survival between the two groups.

Conclusions

The modified technique of transanal specimen extraction in laparoscopic anterior rectal resection abides by the rules of NO TUMOR. It has such advantages as minor trauma, fast recovery, less complications, and satisfactory follow-up when used in lower sigmoid colon or upper rectal cancer.

Key words: Colorectal neoplasms, Laparoscopes, Proctocolectomy, restorative, Treatment outcome

Si Yu, Jianzhong Deng, Yong Ji, Yiban Lin, Qiaoling Wu. A modified technique of transanal specimen extraction in laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon carcinoma[J]. Chinese Archives of General Surgery(Electronic Edition), 2016, 10(04): 264-267,290.

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URL: https://zhptwkxwx.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0793.2016.04.008

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References 18

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组别	例数	年龄（岁， ± s）	性别（例）		肿瘤直径^a	肿瘤部位（例）		肿瘤分化（例）
组别	例数	年龄（岁， ± s）	男	女	（cm, ± s)	乙状结肠下段	直肠上段	高	中	低
观察组	48	46~76(61.7±6.6)	26	22	3~5(4.1±0.5)	21	27	8	35	5
对照组	168	46~81(60.3±7.7)	90	78	4~7(4.6±0.6)	78	90	36	114	18
统计值	?	1.145	0.005		5.272	0.108		?	0.557	?
P值	?	0.235 ^b	0.942 ^c		0.000 ^b	0.743 ^c		?	0.757 ^c	?

组别	例数	年龄（岁， ± s）	性别（例）		肿瘤直径^a	肿瘤部位（例）		肿瘤分化（例）
组别	例数	年龄（岁， ± s）	男	女	（cm, ± s)	乙状结肠下段	直肠上段	高	中	低
观察组	48	46~76(61.7±6.6)	26	22	3~5(4.1±0.5)	21	27	8	35	5
对照组	168	46~81(60.3±7.7)	90	78	4~7(4.6±0.6)	78	90	36	114	18
统计值	?	1.145	0.005		5.272	0.108		?	0.557	?
P值	?	0.235 ^b	0.942 ^c		0.000 ^b	0.743 ^c		?	0.757 ^c	?

组别	例数	手术时间（min, ± s)	出血量（ml, ± s)	肛门排气时间（h， ± s）	术后VAS评分( ± s)	术后并发症（例）	术后住院天数（d， ± s）	术后TNM分期（例）
组别	例数	手术时间（min, ± s)	出血量（ml, ± s)	肛门排气时间（h， ± s）	术后VAS评分( ± s)	术后并发症（例）	术后住院天数（d， ± s）	Ⅰ	Ⅱ	Ⅲ
观察组	48	143±9	62±7	65±6	3.9±1.3	6	6.0±1.0	8	24	16
对照组	168	140±11	60±7	63±8	4.5±1.2	20	7.1±1.2	20	97	51
统计值	?	t=1.730	t=1.746	t=1.607	t=2.998	χ²=0.012	t=5.799	?	χ²=1.159	?
P值	?	0.108	0.320	0.089	0.003	0.911	<0.01	?	0.560	?

组别	例数	手术时间（min, ± s)	出血量（ml, ± s)	肛门排气时间（h， ± s）	术后VAS评分( ± s)	术后并发症（例）	术后住院天数（d， ± s）	术后TNM分期（例）
组别	例数	手术时间（min, ± s)	出血量（ml, ± s)	肛门排气时间（h， ± s）	术后VAS评分( ± s)	术后并发症（例）	术后住院天数（d， ± s）	Ⅰ	Ⅱ	Ⅲ
观察组	48	143±9	62±7	65±6	3.9±1.3	6	6.0±1.0	8	24	16
对照组	168	140±11	60±7	63±8	4.5±1.2	20	7.1±1.2	20	97	51
统计值	?	t=1.730	t=1.746	t=1.607	t=2.998	χ²=0.012	t=5.799	?	χ²=1.159	?
P值	?	0.108	0.320	0.089	0.003	0.911	<0.01	?	0.560	?

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