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ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2009, Number 3

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Cir Gen 2009; 31 (3)

Surgical laparoscopic treatment of cancer of the rectum

González QH, Castañeda AR, Rodríguez ZHA

Language: Spanish
References: 32
Page: 150-158
PDF size: 57.05 Kb.


ABSTRACT

Objective: To assess the experience attained at the Instituto Nacional de Ciencias Médicas y Nutrición "Dr. Salvador Zubirán" in patients with cancer of the rectum treated with laparoscopic surgery. Setting: Third level health care hospital. Design: Observational, descriptive, transversal study. Statistical analysis: Central tendency measures and percentages as summary measure for qualitative variables. Patients and methods:Thirty patients with cancer of the rectum and treated with minimally invasive surgery. Analyzed variables were: age, gender, size and site of the lesion, conversion, surgical time, type of reconstruction, complications, in-hospital stay, start of oral feeding, proximal, distal, and radial margins of the specimen, number of metastized lymphatic ganglia, neurovascular inervation, and recurrence during follow-up. Results: Mean surgical time was 148 min (125-240), mean operative bleeding amounted to 320 ml (200-450), in-hospital stay was of 6 days (4-12) and oral feeding started in an average of 2 post-surgery days (1-5 days). Eleven abdominoperineal resections (APR) and 19 low anterior resections (LAR) were performed. Two patients required conversion (6.6%). In the anatomopathological study, all surgical margins resulted negative with an average of analyzed ganglia in the specimens of 15.69 (± 3.4). Nine patients (30%) presented post-surgical complications. After a mean follow-up of 12 months (9-15), three (10%) recurrences were diagnosed in patients with stage IV cancer. Conclusion: Laparoscopic surgical treatment of cancer of the rectum is feasible, with an acceptable morbidity and mortality rate; it is technically strenous and requires an adequate surgical training, as well as the development of abilities and skills of minimally invasive surgery.


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