Anal function-preserving subtotal intersphincteric resection/partial external sphincteric resection with hybrid 2-port hand-assisted laparoscopic surgery (Mukai's operation) for very low stage I rectal cancer: A case report

Mukai, Masaya; Sekido, Yasutomo; Fukumitsu, Hiroshi; Hayashi, Izumi; Hoshikawa, Tatsuhiko; Tajima, Takayuki; Tobita, Kazuteru; Sadahiro, Sotaro; Yasuda, Seiei; Ogoshi, Kyoji

doi:10.3892/ol.2011.327

Cited by 5 publications

(3 citation statements)

References 9 publications

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“…The results of our multiple studies showed that both short-term and long-term outcomes were comparable between HALS and CL (13,14). In addition, we reported other advantages of HALS, including minimum surgical invasiveness due to small incision, decreased incidence of operative site infection, shorter postoperative hospital stay period, and surgical technique with 2-3 ports, as well as medical costs (13)(14)(15)(16)(17). This time, we also investigate the causes of death.…”

Section: Discussionmentioning

confidence: 78%

Efficacy of hand-assisted laparoscopic surgery (HALS) in older adult patients (≥80 years) with primary colorectal cancer

Koike

Mukai

Abe

et al. 2022

J Gastrointest Oncol

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Background: From 2004 to 2014, 821 colorectal cancer primary resections were conducted at our institution. Of these, 102 patients (12.4%) were older adults over 80 years old. underwent either the conventional laparotomy group (72 patients) or the hand-assisted laparoscopic surgery (HALS) group (30 patients).Methods: Data were extracted for 102 patients over 80 years old who underwent primary resection for colorectal cancer and were divided into two groups: conventional laparotomy (CL) (n=72) and hand-assisted laparoscopy (n=30). Pre-operative characteristics and outcomes were compared.Results: Baseline characteristics were similar between groups, except for age: CL group median 83.5 years old (range, 80-92 years old) and hand-assisted laparoscopy (HALS) group median 81.5 years old (range, 80-88 years old) (P=0.027). Pre-operative cardiac and lung function risk, performance status, and pathological classification stage (pStage) were almost similar between groups (P=0.668, P=0.176, P>0.999, P=0.217). No significant differences were found for operation time. The HALS group resulted in less blood loss (median 204 mL in the CL group and median 68 mL in the HALS group, P=0.003), shorter postoperative hospital stay (median was 18 days in the CL group and median was 12 days in the HALS group, P<0.001), and fewer postoperative wound infections (18 cases in the CL group and 2 cases in the HALS group, P=0.034). Five-year relapse-free survival (5Y-RFS) was 48.1% in the CL group and 73.3% in the HALS group (P=0.028). Five-year overall survival (5Y-OS) was 48.2% in the CL group and 73.3% in the HALS group (P=0.027).Conclusions: Approximately 70% of surgical treatment for patients over 80 years old with colorectal carcinoma were performed by CL. However, HALS had significant advantages including less blood loss, fewer wound infections, and shorter hospital stays. Therefore, HALS could proactively be considered to older adult patients with colorectal cancer.

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Section: Discussionmentioning

confidence: 78%

Efficacy of hand-assisted laparoscopic surgery (HALS) in older adult patients (≥80 years) with primary colorectal cancer

Koike

Mukai

Abe

et al. 2022

J Gastrointest Oncol

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“…But the remarkable magnified view provided by the monitor of laparoscopic operation system has become more advantageous and fascinating and enables safe and accurate manipulation at sites such as the deep pelvic floor, lower bladder, posterior surface of the prostate and anal region, where visualization is difficult to achieve during open surgery and manipulation is usually carried out under nearly blind conditions [13].…”

Section: Discussionmentioning

confidence: 99%

3-Port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance

Zhang¹,

Zhang²,

Wang³

et al. 2013

CRCM

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Introduction: To present the initial experience of 3-port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance by using a toothed oval clamp. Case Presentation: One patient received 3-port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance by using a toothed oval clamp. Better direct vision and exposure could be acquired for performing laparoscopic surgical procedure, avoiding additional port inserted. Using this procedure, with strictly adhering to the principles of laparoscopic colectomy and oncological procedure, along with the specimen exteriorized via recta, transacted and a stapled anastomosis performed, no incision can be achieved at the end of an operation. The operative time was 180 minutes. The estimated blood loss in the course of an operation was 80 ml. The patient recovered quickly after surgery, with no post-operative pain and no incision. The patient was dischanged home on the 6th postoperative day. Conclusions: With a transrectal assistance by using a toothed oval clamp, 3-port laparoscopic surgery for rectal cancer could be achieved without no incision at the end of the operation, the same as NOTES. It is enormously advantageous to the patient and suitable for application in developing countries, especially in a rural area.

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“…However, the scar on the abdomen caused by this procedure may cause dissatisfaction in some patients. In recent years, some researchers have reported transanal specimen extraction in laparoscopic anterior rectal resection [6][7][8], including intersphincteric resection (ISR) [9][10][11], and rectal eversion-resection [12,13]. However these surgical procedures have certain limitations.…”

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confidence: 99%

A modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon cancer: a retrospective study

Luo

et al. 2021

BMC Surg

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Background In recent years, natural orifice specimen extraction surgery (NOSES) has become a field of special interest for colorectal surgeons. Some researchers have reported transanal specimen extraction in the laparoscopic anterior rectal resection, including intersphincteric resection (ISR) and rectal eversion-resection. However, these surgical procedures have certain limitations. Based on the proven expertise in laparoscopic surgery, our center has developed a modified technique of transanal specimen extraction. The aim of this study was to investigate the safety and feasibility of a modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection. Methods From January 2011 to January 2014, the patients with upper rectal or lower sigmoid colon cancer who had undergone laparoscopic anterior rectal resection with specimen extraction by a modified transanal technique were enrolled in the observation group, and the patients who had undergone laparoscopic anterior rectal resection with specimen extraction via an abdominal incision by the same surgeons during the same period were enrolled in the control group. Results A total of 36 patients were included in the observation group and 128 patients were included in the control group. There were no significant differences (P > 0.05) between the two groups in terms of the mean operative time [144 ± 10 min vs. 141 ± 11 min], mean intraoperative blood loss [63 ± 6 ml vs. 61 ± 7 ml], and the mean time to anal exhaust [67 ± 7 h vs. 65 ± 8 h]. However, there were significant differences (P < 0.05) between the two groups in terms of the mean postoperative Visual Analogue Scale (VAS) pain scores [3.4 ± 1.1 vs. 4.5 ± 1.2], mean postoperative hospital stay [6.0 ± 1.1 days ± vs. 7.2 ± 1.2 days], and incidence of postoperative complications (4/36 vs. 15/128). Long-term follow-up results showed that there was no significant difference (P > 0.05) between the two groups in terms of the 3- or 5-year overall survival. Conclusions The modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection fulfilled the principle of no-neoplasm touch technique, with advantages, such as minimal trauma, rapid recovery, and fewer complications. Long-term follow-up results also showed satisfactory oncological outcomes.

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Anal function-preserving subtotal intersphincteric resection/partial external sphincteric resection with hybrid 2-port hand-assisted laparoscopic surgery (Mukai's operation) for very low stage I rectal cancer: A case report

Cited by 5 publications

References 9 publications

Efficacy of hand-assisted laparoscopic surgery (HALS) in older adult patients (≥80 years) with primary colorectal cancer

Efficacy of hand-assisted laparoscopic surgery (HALS) in older adult patients (≥80 years) with primary colorectal cancer

3-Port incisionless laparoscopic surgery for rectal cancer with a transrectal assistance

A modified technique of transanal specimen extraction in the laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon cancer: a retrospective study

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