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Macau Periodical Index (澳門期刊論文索引)
- Author
- Li, KW
- Title
- Thchniques of Laparoscopic total mesorectal excision
- Journal Name
- 澳門醫學雜誌
- Pub. Info
- 2004年6月26日, Vol.4, No.2, pp. 81-84
- Keyword
- Laparoscopy; Total mesorectal excision; Rectal neoplasm
- Abstract
- Objective: Total Mesorectal excision (TME) is the current gold standard treatment for low and mid rectal cancer. Although laparoscopic colorectal surgery has been around for over ten years, it is only recently that laparoscopic TME was reported. Method: Patients with non-metastatic low and mid rectal cancers were selected for laparoscopic TME. The operation was carried in four stages with the patient in Lloyd-Davis position: (1) Mobilization of return and sigmoid colon;(2) Mobilization of distal transverse colin and splenic flexure;(3) Exteriorization and resection of specimen with creation of colinic J-pouch;(4) Intracorporeal anastomosis and covering ileostomy. Results: From May 1999 to May 2001,30 patients underwent laparoscopic TME. The average operation time and blood loss were 180 minutes and 80 ml respectively. There was no conversion or procedure related mortality. Half of the patients had Duckes' C disease. At a median follow-up of 12.5 months, there was no local ore post-site recurrence. Four patients developed distant metastais. Cancer-related death rate was 6.7%. Conclusion: Laparoscopic TME is safe and feasible in well selected patients with low and mid rectal cancers. Paragraph Headings： 1. Why laparoscopic TME? 2. Selection of patients for laparoscopic TME 3. The operation 3.1. Mobilization of the sigmoid colon and rectum 3.2. Mobilization of the Distal Transverse Colon and Splenic Flexure 3.3. Exteriorization and Resection of the specimen, and creation of the colonic J Pouch 3.4. Intracorporeal anastomosis and creation of covering ileostomy 4. Results of laparoscopic TME 5. Conclusion