Specimen Extraction from the Defunctioning Ileostomy Site or Pfannenstiel Incision During Total Laparoscopic Low Anterior Resection for Rectal Cancer

Karakayalı, Feza; Tezcaner, Tugan; Moray, Gökhan

doi:10.1089/lap.2014.0545

Cited by 12 publications

(26 citation statements)

References 24 publications

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“…The incidence of parastomal hernia during stoma closure in the RLT group was 40 %, which is high compared with the 3–19 % values reported in previous series that studied the feasibility and safety of right and left lower transverse incisions for specimen extraction and simultaneous stoma sites during laparoscopic radical proctectomy [20, 23]. Although several factors affect the parastomal hernia rate, the rectus muscle cutting technique used in the present study may have been responsible for the high rate observed.…”

Section: Discussionmentioning

confidence: 63%

“…Given the similar percentages of patients that required splenic flexure mobilization in the two groups of this study, it is believed that the use of a right lower transverse incision for laparoscopic left-sided radical colorectal resection has no detrimental impact on splenic flexure mobilization. Karakayali et al [20] suggested a right lower transverse incision for laparoscopic radical proctectomy had advantages over a Pfannenstiel incision with respect to additional mini-laparotomy, cosmesis, and postoperative course. These suggestions and findings in the present study support the opinion that a right lower transverse incision can be used as an alternative to other transverse incisions such as Pfannenstiel and left lower transverse incisions.…”

Section: Discussionmentioning

confidence: 99%

“…Given previous studies reporting a comparable wound complication rate between left lower transverse incisions and vertical incisions [14, 15], the iliac fossa area is considered an appropriate specimen extraction site for laparoscopic radical resection. Although the right lower transverse incision is reported to be an extraction site in single-incision laparoscopic left-sided colorectal resection [18, 19], and in radical proctectomy when the specimen extraction site is also used as the stoma site [20], few studies have addressed the usefulness of the right lower transverse area as an extraction site in patients undergoing laparoscopic surgery for left-sided colorectal cancer.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Right lower transverse incision versus vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer: a comparative study of two mini-laparotomy techniques

Shin

2016

World J Surg Onc

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BackgroundThe aim of this study was to compare the short-term outcomes of a right lower transverse incision with a vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer.MethodsOne hundred eighty-three patients who underwent laparoscopic resection for rectosigmoid colon or upper rectal cancer were included. Propensity score matching was performed to reduce bias caused by differences between the right lower transverse incision (RLT group) and vertical transumbilical incision (VTU group).ResultsAfter matching, 57 patients in the RLT group and 57 patients in the VTU group were found to be equivalent regarding baseline clinicopathological characteristics. Median follow-up time was 31 months. The RLT group showed comparable results to those of the VTU group in terms of perioperative outcomes, postoperative course, and postoperative complications. However, the proportion of patients requiring an additional incision for diverting stoma was significantly lower in the RLT group (p = 0.003).ConclusionsA right lower transverse incision appears to be as effective as a vertical transumbilical incision regarding short-term outcomes after laparoscopic surgery for left-sided colorectal cancer and may be a preferred extraction site because of its lowered risk of additional mini-laparotomy for diverting stoma.

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Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Right lower transverse incision versus vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer: a comparative study of two mini-laparotomy techniques

Shin

2016

World J Surg Onc

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“…Laparoscopic rectal cancer surgery (LRCS) has been recently shown to be advantageous in terms of postoperative recovery and oncologic results similar to that with open surgery in large randomized studies [11,12], and thus, the application of this procedure is increasing [13]. Specimen extraction following LRCS is possible through the anus [14][15][16], but in most cases, it is achieved through the low transverse abdomen, midline abdomen or potential stoma site [1,5,[17][18][19]. Some studies [17][18][19] have also attempted specimen extraction through stoma site (SESS) to minimize additional mini-laparotomy for a temporary diverting stoma in LRCS.…”

Section: Introductionmentioning

confidence: 99%

“…Specimen extraction following LRCS is possible through the anus [14][15][16], but in most cases, it is achieved through the low transverse abdomen, midline abdomen or potential stoma site [1,5,[17][18][19]. Some studies [17][18][19] have also attempted specimen extraction through stoma site (SESS) to minimize additional mini-laparotomy for a temporary diverting stoma in LRCS. Recent studies [20,21] reported the feasibility of SESS utilizing umbilicus in LRCS.…”

Section: Introductionmentioning

confidence: 99%

Short-term and Medium-term Outcomes of Low Midline and Low Transverse Incisions in Laparoscopic Rectal Cancer Surgery

Kim

Shin

2020

Ann Coloproctol

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Limited data exist on the use of low midline and transverse incisions for specimen extraction or stoma sites in laparoscopic rectal cancer surgery (LRCS). We compared the short-term and medium-term outcomes of these incisions, and assessed whether wound complications of specimen extraction site (SES) are increased by specimen extraction through stoma site (SESS) in LRCS. Methods From March 2010 to December 2017, 189 patients who underwent LRCS and specimen extraction through low abdominal incisions were divided into two groups: midline (n=102) and transverse (n=87) groups, and perioperative outcomes were compared. Results The midline group showed higher the frequency of temporary stoma formation (p=0.001) and splenic flexure mobilization (p<0.001) than transverse group. The overall incisional hernia and wound infection rates in the SES were 21.6% and 25.5%, respectively, in the midline group and 26.4% and 17.2%, respectively, in the transverse group (p=0.494 and p=0.232, respectively). In patients who underwent SESS, the incisional hernia and wound infection rates of SES after stoma closure were 39.1% and 43.5%, respectively, in the midline group, and 35.5% and 22.6%, respectively, in the transverse group (p=0.840 and p=0.035, respectively). Conclusions In terms of incisional hernia and wound infection of SES, a low midline incision may be used as a low transverse incision in patients without temporary stoma in LRCS. However, considering the high wound complication rates after stoma closure in patients with SESS in this study, SESS would be performed with caution in LRCS.

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Comparison of specimen extraction site and another site for protective loop ileostomy in laparoscopic low anterior rectal resection: a retrospective comparative study

Liu

Zhang

et al. 2023

Langenbecks Arch Surg

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Background Protective loop ileostomy is commonly performed in laparoscopic low anterior rectal resection to prevent the serious complications of anastomotic fistula. It is usually created at the right lower quadrant of the abdomen and another wound is required for stoma. The study aimed to evaluate the outcomes of ileostomy at the specimen extraction site (SES) and another site (AS) beside the auxiliary incision. Methods A retrospective analysis was conducted on 101 eligible patients with pathologically diagnosed adenocarcinoma of the rectum from January 2020 to December 2021 in the study center. According to whether the ileostomy was at the specimen extraction site, patients were divided into SES group (40 patients) and AS group (61 patients). Clinicopathological characteristics, the intraoperative details, and postoperative outcomes of the two groups were measured. Results Univariate analysis showed that the operative time was significantly shorter and the blood loss was significantly less in the SES group than in the AS group during laparoscopic low anterior rectal resection, the time to first flatus was significantly shorter, and the pain was significantly less in the SES group than in the AS group during ileostomy closure. The postoperative complications were similar in both groups. Multivariable analysis showed that ileostomy at the specimen extraction site was a significant factor influencing the operative time and blood loss of rectal resection, and influencing the pain and the time to first flatus during ileostomy closure. Conclusion Compared to ileostomy at AS, protective loop ileostomy at SES was time-saving and less bleeding during laparoscopic low anterior rectal resection, and more quick to first flatus and less pain during stoma closure, and did not lead to more postoperative complications. The median incision of the lower abdomen and the left lower abdominal incision were both good sites for ileostomy.

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Specimen Extraction from the Defunctioning Ileostomy Site or Pfannenstiel Incision During Total Laparoscopic Low Anterior Resection for Rectal Cancer

Cited by 12 publications

References 24 publications

Right lower transverse incision versus vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer: a comparative study of two mini-laparotomy techniques

Right lower transverse incision versus vertical transumbilical incision for laparoscopic specimen extraction in patients with left-sided colorectal cancer: a comparative study of two mini-laparotomy techniques

Short-term and Medium-term Outcomes of Low Midline and Low Transverse Incisions in Laparoscopic Rectal Cancer Surgery

Comparison of specimen extraction site and another site for protective loop ileostomy in laparoscopic low anterior rectal resection: a retrospective comparative study

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