2000, Number 3
Cir Gen 2000; 22 (3)
Franklin MEJ, Abrego MD,Glass J, Obregón CL, Díaz EJA
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ABSTRACTObjective: The aim of this article is to describe our experience in Laparoscopic Abdomino-Perineal Resection (LAPR).
Patients and methods: 36 patients with rectal adenocarcinoma were studied in a prospective way. According to TNM they were classified as follows. Stage I, 1 patient; stage II, 18; stage III, 11; and stage IV, 6.
Results: Surgical blood loss was 244.39 ± 143.56 ml. Early complications occurred in 10 patients. Perineal infection, 3; pneumonia, 2; post-operatory ileus, 2; post-operatory bleeding, 1; hematoma, 1; massive pulmonary embolism, 1. There was no case of infection at the port insertion areas. Late complications occurred in 5 patients: perineal hernia, 1; neurogenic bladder, 1; intestinal obstruction secondary to adhesions, 3 (2 of them required surgical intervention to solve it). Patient in stage I still Alive With No Evidence of Disease (ANED) after a 28-month follow-up management. Stage II patients: Mortality 27.7% (46±22.59 months of average survival). ANED 72.2% (32.88 months of follow-up management). No patient with recurrence (AED). Stage III patients: Mortality 36.36% (32±18.57 months of average survival), ANED 63.63% (45.57 months of average follow-up management). Stage IV: Mortality 33.5% (31 months of average survival) y AED 66.6% (34.33 months of follow-up management). No patient has shown recurrence at the port insertion areas.
Conclusion: LAPR is a safe approach for treating rectal carcinoma, with fewer incidences of complications both at early and late stages. Survival and recurrence are similar to that reported in worldwide literature.