Minimally Invasive Colorectal Resection in Kidney Transplant Recipients: Technical Tips, Short- and Long-Term Outcomes

Abstract

Aim. To prove the safety and feasibility of minimally invasive (laparoscopic and robotic) colorectal resection in kidney recipients by evaluating the technical protocol and reviewing short- and long-term outcomes. Methods. Between May 2007 and August 2012, a retrospective review of ten kidney transplant patients diagnosed with colorectal cancer was evaluated for technical tips, short- and long-term outcomes. Results. The mean patients' age was 56.8 ± 9.91 years and 50% of them were male. Anterior and low anterior resections were performed in 40% of the patients each; 20% and 10% of the patients underwent right and left hemicolectomy, respectively. Most (90%) procedures were performed laparoscopically and 10% were performed robotically. No open conversions. Mean operating time was 192.5 ± 15 min, blood loss was 30 ± 50 mL, and mean hospital stay was 9.7 ± 5.5 days. Two (20%) patients had postoperative complications: wound seroma and chyloperitoneum. Over a mean follow-up period of 31.4 ± 21.57 months, no mortality or kidney rejection occurred. Among the six patients followed up for a mean of 43.5 ± 9.84 months, 83.3% were 3-year disease-free and the overall survival rate was 100%. Conclusion. Minimally invasive colorectal resection is likely to be safe and feasible, with fewer complications and acceptable short- and long-term outcomes, in kidney transplant recipients.

Laparoscopic Surgery for Sigmoid Colon Cancer in a Patient With a History of Two Renal Transplantation and Peritoneal Dialysis

“…Four cases involving laparoscopic surgery for colorectal cancer after kidney transplantation have been reported [7][8][9][10] by a case series comprising 19 patients with colorectal cancer after kidney transplantation who underwent laparoscopic or robotic surgery (Table 1). One kidney transplantation was performed for each of these four cases.…”

“…The long-term prognosis was also favorable. Alasari et al [7] reported that among the 10 patients who underwent laparoscopic or robotic surgery for colorectal cancer after kidney transplantation, the three-year disease-free rate was 83.3%, and the three-year overall survival rate was 100%.…”

Laparoscopic assisted low anterior resection for advanced rectal cancer in a kidney transplant recipient

“…Therefore, transplant recipients seem to benefit more from the minimal access approach. Alasari [ 26 ] evaluated short- and long-term outcomes of minimally invasive (laparoscopic and robotic) colorectal resection in 10 kidney transplant recipients with CRC between May 2007 and August 2012. Having observed a favorable result in operative time (192.5 ± 15 min), blood loss (30 ± 50 mL), and postoperative complication (2/10 minor complications), they proposed minimally invasive colorectal procedures could be considered as safe and feasible alternatives to open colorectal resection in kidney transplant patients.…”