LAPAROSCOPIC SPHINCTER-SAVING PROCEDURE FOR LOW RECTAL CANCER
作者单位：Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea Dept. of Surg. St. Vincent’s Hospital The Catholic University of KoreaSuwon Republic of Korea
会议名称：《第六次全国大肠癌会议暨中日韩大肠癌会议》
会议日期：1998年
学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学]
摘 要：正PURPOSE: High-dose preoperative radiotherapy has shown promising results in the treatment of low rectal cancer（LRC）. Laparoscopic procedure provides an enhanced view of the pelvic cavity that is not available by conventional method. We developed a sphincter-saving procedure combining the advantages of preoperative radiotherapy and laparoscopy for preserving anatomic and physiologic anal function. Our purpose is to show detailed information regarding procedure and early results. METHODS: From February 1996 to August 1997, eleven patients with LRC underwent the operation. Mean age was 56.1 years. Tumor located 4～8 cm from anal verge. All patients were treated with high-dose preoperative irradiation （4500～5040 cGy） over a period of 5 weeks. All were given our procedure four and a half to eight weeks after completion of radiation. Left colon and rectum were mobilized by laparoscopic oncologic dissection down to puborectalis muscle, after which specimen retrieval and coloanal anastomosis were performed transanally. We concluded with temporary transverse colostomy for fecal diversion. Careful follow-up of 4 to 21 months has so far been given. RESULTS: Every case was successful without any significant complication, and all revealed advantages of laparoscopy. There was one case of complete remission following radiation, and five were stage Ⅰ, four stage Ⅱ, and one stage Ⅲ. Margin from the tumor was 1～5 cm distally, 19～32 cm proximally, 0.3～3.5 cm laterally. We had one local recurrence 11 months after operating. CONCLUSION: We have termed our procedure ’Laparoscopic Abdominal Transanal （LATA） Proctosigmoidectomy with coloanal anastomosis （LATA resection）’, and propose it as a functional and curative alternative for LRC while continuing to evaluate its efficacy.