A comparison of resection margins and lymph node clearance in laparoscopic vs open anterior and abdomino-perineal resections for carcinoma of rectum

K B Galketiya,R A A Shaminda,T M S U B Thennakoon,E D K N Ariyarathna,V Pinto

doi:10.4038/gmj.v22i1.7960

Abstract

Introduction: Laparoscopic anterior and abdomino-perineal resections for carcinoma rectum are associated with a lower morbidity than open surgery. It is important to evaluate laparoscopic resections against open surgery for tumour free resection margins and lymph node clearance. Methods: A retrospective analysis of resection margins and number of lymph nodes harvested at anterior and abdomino-perineal resections performed by laparoscopy and open surgery was done. Results: There was no statistically significant difference in the tumour free resection margins while lymph node clearance was significantly higher in the laparoscopy group. Conclusion: Laparoscopic surgery for carcinoma rectum provides a satisfactory oncological outcome with regards to clear resection margins and lymph node harvest.

Highlights

Anterior resection and abdomino-perineal resection are the curative resections for carcinoma of the rectum
This study was designed to evaluate resection margins and lymph node clearance of laparoscopic anterior resections and abdominoperineal resections performed in our unit
A retrospective analysis of resection margins and number of lymph nodes harvested at anterior resection and abdomino-perineal resections performed from January 2014 to April 2016was done and compared with open surgeries performed during the same period

Summary

Introduction

Anterior resection and abdomino-perineal resection are the curative resections for carcinoma of the rectum. Anterior resection is possible when the anus and sphincters can be preserved while having a resection margin of 3cm. Minimal access resections reduce the length of exposure incision while having a clear vision with magnification facilitating the resection [1]. The first laparoscopic assisted left hemicolectomy performed in 1991 reported to have reduced morbidity [2]. The postoperative morbidity is reduced allowing early mobilization, early feeding and discharge [1, 7]. Acceptable resection margins and satisfactory lymph node clearance have been reported [7, 8]. This study was designed to evaluate resection margins and lymph node clearance of laparoscopic anterior resections and abdominoperineal resections performed in our unit

Methods

Results

Conclusion