Redo rectal surgery – is there a role for laparoscopy?

This study reviewed the applicability of laparoscopy in this challenging setting.MethodsRetrospective analysis of patients who underwent trans-abdominal re-operative rectal surgery from 2010-2019 was performed.ResultsSeventy-eight patients [35 females (45%); BMI 25kg/m2) were included. Reasons for reoperation were recurrent cancer in 18 (43%) patients and anastomotic failure in 57 (73%). Twenty-two (28%) had laparoscopic surgery and 4 had attempted laparoscopy converted to laparotomy. A higher success rate was noted for laparoscopy with prior laparoscopic surgery. Benefits of laparoscopy included significant reduction in length of stay (6.7 vs 9.7 days, p=0.012) and abdominal superficial surgical site infection (0% vs 25%, p
Source: The American Journal of Surgery - Category: Surgery Source Type: research

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AbstractTo compare short-term postoperative outcomes in patients undergoing robotic total mesorectal excision (TME) after the use of robotic and laparoscopic staplers. Over a 5-year period, 196 patients were divided into 2 groups according to the use of laparoscopic (LS) or robotic stapler (RS). Patient demographics and postoperative complications were compared. A total of 145 (74%) robotic TME were performed using the LS and 51 (26%) the RS. No conversions to laparoscopy or laparotomy were observed, in either group. Transection of the rectum using one or two firings was achieved in a higher proportion of RS cases (91%) co...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
Objective: The aim of the study was to determine the efficacy of laparoscopic rectal resection (Lap) versus open laparotomy and rectal resection (Open) for rectal cancer on locoregional recurrence (LRR) and disease-free survival (DFS) at 2 years. Summary background data: Although a Lap approach to colon cancer surgery may offer similar oncological outcomes to Open with potentially less morbidity, this remains to be clearly established for the treatment of rectal cancer. Methods: A randomized, multicenter noninferiority phase 3 trial of 475 patients with T1 to T3 rectal adenocarcinoma
Source: Annals of Surgery - Category: Surgery Tags: FEATURES Source Type: research
This study aims to evaluate the clinical value of SL in treatment decision-making for advanced rectal cancer (RC) with near or complete obstructing tumors. Observational review of colorectal database at Tata Memorial Hospital from January 2013 to December 2016 identified 562 patients diagnosed and treated for advanced RC. Of the 562 cases, 48.7% (274) were clinically and radiologically diagnosed of near or complete obstructing advanced RC. Medical records of 34% (94/274) who underwent SL with diversion stoma (DS) were analyzed. In the absence of ascites, extensive peritoneal deposits, and unresectable liver metastases on S...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Clinics in Colon and Rectal Surgery 2017; 30: 333-338 DOI: 10.1055/s-0037-1606110The curative treatment of locally advanced rectal cancer is currently based on chemoradiotherapy and total mesorectal excision (TME). Laparoscopy has developed considerably because of obvious clinical benefits such as reduced pain and shorter hospital stay. Recently, several prospective randomized clinical trials with long-term follow-up have showed that laparoscopy is noninferior to laparotomy with the same oncologic outcomes in terms of survival and local control rate. However, laparoscopic TME remains a challenging procedure requiring a hig...
Source: Clinics in Colon and Rectal Surgery - Category: Surgery Authors: Tags: Review Article Source Type: research
AbstractBackgroundPostoperative mortality after resection of colorectal cancer is an important issue. The aim of this study was to assess early postoperative mortality in a well-defined French population.MethodsData on 30- and 90-day postoperative mortality after resection for colorectal cancer were extracted from the digestive cancer registry of Burgundy. Time trends of postoperative mortality between 1989 and 2013 were described for the large population. Case-control studies (death within 30 or 90  days = cases, alive at 90 days = controls) focused on the association between postoperative mortality an...
Source: International Journal of Colorectal Disease - Category: Gastroenterology Source Type: research
Conclusion We present a case of spontaneous small bowel intussusception after laparoscopic total mesorectal excision for rectal cancer that was treated by surgical resection 5 days after the index surgery.
Source: Military Medical Research - Category: Global & Universal Source Type: research
ConclusionIn validation of external and recent cohorts, the predictive accuracy was strong in colon cancer and moderate in rectal cancer patients. The model can be used to identify high‐risk patients for planned second look laparoscopy/laparotomy for possible subsequent cytoreductive surgery and hypertermic intraperitoneal chemotherapy.This article is protected by copyright. All rights reserved.
Source: Colorectal Disease - Category: Gastroenterology Authors: Tags: Original Article Source Type: research
Current study aims to analyze the impact of previous vertical laparotomy on safety and feasibility of laparoscopic sigmoid colon and rectal cancer operations.
Source: International Journal of Surgery - Category: Surgery Authors: Tags: Original Research Source Type: research
Conclusion: We present our preliminary experiences of robotic colorectal surgery and demonstrate that robotic colorectal surgery is a safe and feasible surgery even when conducted by laparoscopic surgeons with limited experience.
Source: BMC Surgery - Category: Surgery Authors: Source Type: research
Conclusions Nerve-guided laparoscopic total mesorectal excision for distal rectal cancer is safe and feasible. This technique should be considered whenever possible as a means to prevent autonomic nerve damage and subsequent loss of urogenital function.
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
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