Study of surgical feasibility and outcome of laparoscopic surgery in malignant rectal tumors

Abstract

ABSTRACT Objective To assess the viability, limitations, technical challenges, and outcomes of malignant rectal tumors laparoscopic mesorectal resection with the assessment of postoperative continence. Patients and Methods The study involved 20 people who had malignant rectal tumors. All patients underwent laparoscopic mesorectal resection. Data were recorded and investigated during Preoperative, operative, and postoperative periods. Results Low anterior, anterior, and intersphincteric resections were performed in 30%, 7%, and 35% of patients, respectively. The mean operative period lasted was on average of 3.10 ± 0.72 h. Only one case (5%) showed postoperative complications. The peristalsis became audible after one to two days, on an average of 1.65 ± 0.49 days. The hospital staying mean duration was 4.25 ± 0.72. Only for 7 patients with intersphincteric resection, the mean Wexner score was 3.0 ± 1.91 after the closure of ileostomy. Patients who underwent low anterior resection had significantly longer postoperative hospital stays (p = 0.020). There was a substantial relationship between the number of both the resected lymph nodes (LN) and the involved ones (p < 0.001). Conclusion Laparoscopic mesorectal excision for rectal tumors is superior nowadays on traditional open approach, has no increased operative time and has privileges of decreasing postoperative pain, decreasing complications, decreasing the hospital stay, early recovery and fast first bowel motion and helps for better visualization and resection of all related lymph nodes. Intersphincteric mesorectal excision of rectal tumors is preferred for all patients below 60 years old with distal rectal tumors regardless of the tumor lower edge’s extended length from the anal verge as long as the external sphincters are preserved.