Literature DB >> 20857534

Laparoscopic low anterior resection for rectal carcinoma: complications and management in 132 consecutive patients.

Qian-Lin Zhu1, Bo Feng, Ai-Guo Lu, Ming-Liang Wang, Wei-Guo Hu, Jian-Wen Li, Zhi-Hai Mao, Min-Hua Zheng.   

Abstract

AIM: To analyze the clinical manifestations and risk factors of complications in laparoscopic low anterior resection (LAR) for rectal cancer patients.
METHODS: A series of 132 consecutive patients who received laparoscopic LAR for rectal cancer in our center were included. The etiology, diagnosis, treatment and prevention of rectal cancer were studied among the patients with surgery-related complications using both univariate and multivariate regression analysis.
RESULTS: No conversion to open surgery was observed and 5 cases converted to hand-assisted laparoscopic operation. The overall morbidity rate was 20.5%. Complications occurred during the operation in 7 patients (5.3%), within 30 postoperative days in 24 patients (18.2%), and within 3 mo in 2 patients (1.5%). The most significant complications were anastomotic leakage (9.1%) and anastomotic hemorrhage (5.3%). Size and location of tumor, pathological staging and preoperative nutrition were significant factors associated with LAR complications, while gender, age and pathological type showed no relevance. Binary logistics regression showed that the size and location of tumor, and pathological staging were independent factors of laparoscopic LAR. All the complications were treated during their onset of clinical manifestations by interventional or conservative therapy.
CONCLUSION: Anastomotic leakage is a major complication in laparoscopic LAR. The complications may be associated with tumor size and site, and pathological stage. Interventional therapies are of value in the management of laparoscopic LAR complications.

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Mesh:

Year:  2010        PMID: 20857534      PMCID: PMC2945495          DOI: 10.3748/wjg.v16.i36.4605

Source DB:  PubMed          Journal:  World J Gastroenterol        ISSN: 1007-9327            Impact factor:   5.742


  12 in total

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2.  Totally laparoscopic low anterior resection with transperineal handsewn colonic J-pouch anal anastomosis for low rectal cancer.

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3.  Anastomotic leakage after lower gastrointestinal anastomosis: men are at a higher risk.

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4.  Risk factors and clinical outcome for anastomotic leakage after total mesorectal excision for rectal cancer.

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5.  Laparoscopic versus open total mesorectal excision: a comparative study on short-term outcomes. A single-institution experience regarding anterior resections and abdominoperineal resections.

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7.  Prospective comparison of laparoscopic vs. open resections for colorectal adenocarcinoma over a ten-year period.

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9.  A comparison of laparoscopically assisted and open colectomy for colon cancer.

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Review 10.  Outcome of laparoscopic colorectal resection.

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Review 2.  Laparoscopic surgery for colorectal cancer in China: an overview.

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4.  British Society of Gastroenterology/Association of Coloproctologists of Great Britain and Ireland guidelines for the management of large non-pedunculated colorectal polyps.

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5.  The nutritional risk is a independent factor for postoperative morbidity in surgery for colorectal cancer.

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6.  Anorectal functional outcome following laparoscopic low anterior resection for rectal cancer.

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Review 7.  Aspects Towards the Anastomotic Healing in Crohn's Disease: Clinical Approach and Current Gaps in Research.

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Review 8.  Predictive factors for anastomotic leakage after laparoscopic colorectal surgery.

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9.  Systematic review of anastomotic leakage rate according to an international grading system following anterior resection for rectal cancer.

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