EARLY OUTCOMES OF LAPAROSCOPIC SURGERY FOR TREATMENT OF RECTAL CANCER AT CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Hong Quan Dang1,, Van Luan Nguyen 1, Van Tuan Nguyen 1, Van Doi Mai1, Thanh Vu Le 1, Thi Hau Vo 1, Van Nang Pham 1
1 Can Tho University of Medicine and Pharmacy

Main Article Content

Abstract

Background: Rectal cancer is a common disease of digestive tract. Laparoscopic surgery for treatment of rectal cancer has been performed in many parts of the world and in Viet Nam. Circumferential resection margin (CRM) status is one of the strongest predictors in rectal cancer. Objectives: The aims of this study were to identify the early results of laparoscopic surgery for treatment of rectal cancer, to assess the histopathological characteristics and circumferential resection margin status. Materials and methods: In this cross – sectional study, patients with rectal cancer who underwent laparoscopic surgery according to the principles of total mesorectal excision (TME) between July, 2017 and December, 2019 were extracted at Can Tho University of Medicine and Pharmacy Hospital. Identifying the early results of laparoscopic surgery and whole – mount section technique was used to evaluate CRM status. Results: All data and CRM of 54 patients were collected. 28 males and 26 females were included in the study. Mean age 62.3 years. Laparoscopic anterior resection with sphincter-saving TME was performed in 47 patients and Miles procedure in 7 patients. Mean operating time was 254 ± 83 minutes. Mean postoperative period until bowel movement, length of hospital stay was 1,6 and 9,1 days, respectively. Postoperative complications were anastomotic leakage (3.7%); wound infections (3.7%), anastomotic bleeding (3.7%), fecal incontinence (3.7%) and urinary retention (5.5%). Total morbidity was 20.3%, but there were no fatal complications or operative deaths. In 35.2%, the quality of the mesorectum was complete, nearly complete in 53.7%. CRM involvement in 33.3%. Conclusion: Laparoscopic surgery for rectal cancer is a safe procedure. We can routinely perform this method for rectal cancer patients. CRM involvement was 33.3%.

Article Details

References

1. Nguyễn Hoàng Bắc, Nguyễn Hữu Thịnh (2010), Vai trò của phẫu thuật nội soi trong xử trí biến chứng của phẫu thuật nội soi trực tràng, Y học Thành phố Hồ Chí Minh, 14(1), tr 124 - 126.
2. Nguyễn Hoàng Bắc và cộng sự (2006), Cắt toàn bộ mạc treo trực tràng bằng phẫu thuật nội soi trong điều trị ung thư trực tràng thấp, Y học Việt Nam, ĐB(319), tr 131 - 138.
3. Trần Ngọc Dũng và cộng sự (2014), Đánh giá kết quả sớm của phương pháp phẫu thuật nội soi trong điều trị ung thư trực tràng, Y học thực hành, Số 2, tr 35 - 38.
4. Phạm Văn Năng (2014), Phẫu thuật cắt đại trực tràng nội soi trong điều trị ung thư đại - trực tràng, Y học thực hành, 928(8), tr 172 - 174.
5. Đặng Hồng Quân, Phạm Văn Năng (2012), Khảo sát diện cắt vòng quanh trong ung thư trực tràng, Y học thực hành, 818 - 819, tr 491 - 494.
6. Dresen R.C., et al. (2009), Local recurrence in rectal cancer can be predicted by histopathological factors, Eur J Surg Oncol, 35(10), pp 1071-7.
7. Ferlay J., et al. (2013), Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012, International Journal of Cancer.
8. Fukunaga Y., et al. (2010), Laparoscopic rectal surgery for middle and lower rectal cancer, Surg Endosc, 24(1), pp 145-51.
9. Guillou P.J., et al. (2005), Short-term endpoints of conventional versus laparoscopicassisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial, Lancet, 365(9472), pp 1718-26.
10. Heald R.J., Husband E.M., Ryall R.D. (1982), The mesorectum in rectal cancer surgery-the clue to pelvic recurrence?, Br J Surg, 69(10), pp 613-6.
11. Leroy J., et al. (2004), Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes, Surg Endosc, 18(2), pp 281-9.
12. Nagtegaal I.D., et al. (2002), Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control, J Clin Oncol, 20(7), pp 1729-34.
13. Quirke P., et al. (1986), Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tumour spread and surgical excision, Lancet, 2(8514), pp 996-9.
14. Staudacher C., et al. (2007), Total mesorectal excision (TME) with laparoscopic approach: 226 consecutive cases, Surg Oncol, 16 Suppl 1, pp S113-6.
15. Wibe A., et al. (2002), Prognostic significance of the circumferential resection margin following total mesorectal excision for rectal cancer, Br J Surg, 89(3), pp 327-34.