Objective To assess the feasibility and adequacy of Harmonic Scalpel in a totally laparoscopic total mesorectal excision (TME) and low,ultralow,colo-anal anastomoses for rectal cancer.
Methods Excision of the mesorectum and low，ultralow site anastomoses were performed laparoscopically on 30 patients with low rectal cancer based on the concept of TME.
Results All 30 TME were successfully completed by laparoscopic approach, and no one was converted to open procedures. A cholecystectomy and/or an ovariotomy were meanwhile performed laparoscopically for 3 patients with rectal cancer,and 1 patient with chronic cholesyctitis, gallstone,ovarian cyst and torsion of the ovary. The operation time was 155 min (115-320 min). Operative blood loss was 20 ml (5-80 ml).The time of bowel function returned and the time to resume postoperative diet was 1-2 days after the operation. Fourteen patients had postoperative analgesic requirement. Average hospital stay was 8 days (5-14 days) and there were no intraoperative and postoperative complications in all 30 patients.
Conclusion Laparoscopic excision of the mesorectum and low,ultralow,coloanal anastomoses with Harmonic Scalpel for low rectal cancer is a perspective minimally invasive technique, which is feasible, safe, effective and has dramatic high rates of sphincter preservation with decreased postoperative pain, rapid recovery.
Citation：
CHENG Zhong,ZHOU Zongguang,LI Li,et al.. Total Mesorectal Excision and Low，Ultralow，Colo-Anal Anastomoses Laparoscopically with Harmonic Scalpel in the Treatment of Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2002, 9(1): 31-33. doi:
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Copyright © the editorial department of CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY of West China Medical Publisher. All rights reserved
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- 2. Killingback M,Barron P,Dent OF. Local recurrence after curative resection of cancer of rectum without total mesorectal excision [Ｊ]. Dis Colon Rectum, 2001； 44(4)∶473.
- 3. Hartley JE, Mehigan BJ, Qureshi AE, et al. Total mesorectal excision: assessment of the laparoscopic approach [Ｊ]. Dis Colon Rectum, 2001； 44(3)∶315.
- 4. Heald RJ,Husband EM,Ryall RDH.The mesorectum in rectal cancer surgerythe clue to pelvic recurrence [Ｊ]？Br J Surg，1982； 69(10)∶613.
- 5. 张卫，于德洪.全直肠系膜切除术治疗直肠癌 [Ｊ].中华普通外科杂志，1999； 14（4）∶297.
- 6. McCall JL,Cox MR,Wattchow DA.Analysis of local recurrence rates after surgery alone for rectal cancer [Ｊ].Int J Colorec Dis，1995; 10(2)∶126.
- 7. Heald RJ.Total mesorectal excision is optimal surgery for rectal cancer: a scandinavian consensus [Ｊ]. Br J Surg，1995； 82(10)∶1297.
- 8. 黄莚庭.大肠癌诊疗现状与展望 [Ｊ].中国普外基础与临床杂志，2000; 7（1）∶44.
