Totally‐laparoscopic versus laparoscopic‐assisted low anterior resection for rectal cancer: are outcomes different?

Ng, Jia Hui; Lai, Jiunn Herng; Li, Hui Hua; Tan, Enjiu Pauleon; Tang, Choong Leong

doi:10.1111/ans.14841

Cited by 3 publications

(4 citation statements)

References 28 publications

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“…Specimens can be obtained through two natural lumens of the rectum or vagina, and trans-anal removal is more physiological because it does not increase trauma [6] . At present, there are three ways to remove the specimen [6,10] : eversion resection, pull-out resection and pulling out after resection. Each method has its own operating characteristics and skills.…”

Section: Discussionmentioning

confidence: 99%

“…4. To reduce the incidence of postoperative anastomotic leakage, preventive ileostomy is recommended for patients with low rectal cancer complicated with diabetes [6,12] .…”

Section: Discussionmentioning

confidence: 99%

“…This auxiliary incision can cause postoperative pain, increase the risk of incision complications, affect the cosmetics of the abdominal wall, and even bring long-term adverse psychological suggestions to the patient; therefore, how to achieve better minimally invasive results and retain anal function has become a topic of focus. Recently, the trans-anal natural orifice specimen extraction (NOSE) technique, which makes a complete laparoscopic operation without abdominal incision possible, has been widely used in laparoscopic colorectal surgeries [5][6] . However, how to place the anvil in the proximal sigmoid colon is a technical difficulty in alimentary canal reconstruction.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Application of the Reverse Puncture Technique for Total Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction

Kong

Xia

et al. 2020

Preprint

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Objective To explore the feasibility, safety and short-term effects of the reverse puncture technique for total laparoscopic colorectal resection with natural orifice specimen extraction surgery (NOSES). Materials and Methods The clinical data of 28 patients undergoing total laparoscopic anterior resection with NOSE from July 2016 to July 2019 were retrospectively analysed. The operation was performed following the principle of total mesorectal excision. The reverse puncture technique was used to put the anvil into the proximal sigmoid colon. Then, intra-abdominal anastomosis of the proximal colon and distal rectum was carried out, and the short-term efficacy was evaluated. Results All 28 patients successfully underwent surgery, and the average operative time was 186 (160~220) min. The average time of anvil placement was 15 (12~18) min, the blood loss volume ranged from 60 to 150 ml, and the average length of hospital stay was 9.2 (7-11) d. All of the distal resection margins were confirmed to be negative by the pathological results. No surgery-associated complications, such as anastomosis stricture, leakage, or bleeding, were observed, and no local recurrence or metastasis occurred after 6 months of follow-up. Conclusion Reverse puncture for total laparoscopic colorectal resection with NOSE can avoid purse-string sutures under laparoscopy and avoid the auxiliary incision at the abdominal wall, which minimizes pain after operation. This approach is safe and feasible with a shortened hospital stay and rapid recovery, which results in good short-term clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

“…4. To reduce the incidence of postoperative anastomotic leakage, preventive ileostomy is recommended for patients with low rectal cancer complicated with diabetes [6,12] .…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical Application of the Reverse Puncture Technique for Total Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction

Kong

Xia

et al. 2020

Preprint

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“…The optimal treatment for localized gastrointestinal and hepatobiliary cancers, including rectal and pancreatic cancer, includes surgical resection, where possible. However, for these cancers, surgery may be associated with considerable potential morbidity [2][3][4][5]. Furthermore, with the exception of potentially curable oligometastatic rectal cancer, there is no standard role for resecting the primary malignancy in the setting of metastatic disease [6,7].…”

Section: Introductionmentioning

confidence: 99%

Pentixafor as a Theranostic Agent in Rectal and Pancreatic Adenocarcinoma: Outcomes From a Pilot Study

Burge

Ahern

Thomas

et al. 2022

Preprint

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Background: Accurate staging is essential in the management of pancreatic and rectal adenocarcinomas, and where prognosis after management of advanced, unresectable disease remains poor, further treatment options are urgently needed. CXCR4 is the receptor for chemokine CXCL12, with enriched expression in malignant compared with normal tissue, and putative tumorigenic signalling functions. Pentixafor, a peptide targeting CXCR4, is a theranostic agent capable of being labelled with gallium-68 (Ga-68) for positron emission tomography (PET) imaging, and lutetium-177 (Lu-177) for therapy. Using PET scanning, we sought to explore the potential utility of pentixafor as a theranostic agent by examining avidity of Ga-68-pentixafor uptake in a pilot study of patients diagnosed with rectal or pancreatic ductal adenocarcinoma (PDAC). Methods: We performed a single-arm, prospective, single-institution pilot study. Patients with newly diagnosed pancreatic or rectal adenocarcinoma received Ga-68-pentixafor-PET in addition to the usual clinical and radiologic workup for their disease. Suitability for peptide receptor radionucleotide therapy (PRRT) was judged using the Thera-P trial criteria[1]. Using binomial probability, a target of 12 patients was set for recruitment for each cancer cohort, given that if more than seven patients demonstrated insufficient uptake, there would be 95% confidence that a sensitivity threshold which would be deemed to warrant further investigation in a larger study (85%) would not be met. Results Pentixafor-PET was administered to 8 rectal cancer patients and 9 PDAC patients and no adverse events were noted. Low-to-moderate levels of pentixafor tracer avidity was demonstrated at all sites of primary disease, most sites of nodal metastatic disease and some distant metastases in each cohort, although less uptake relative to Fluorodeoxyglucose (FDG)PET/CT was noted suggesting that use of pentixafor is inferior to FDG in staging. No patients satisfied PRRT suitability criteria and further recruitment was terminated.Conclusion: In this small pilot study, insufficient pentixafor avidity was demonstrated in cases of rectal cancer and PDAC to warrant further exploration as a potential candidate for radionuclide therapy. Trial registration: Australia and new Zealand Clinical Trials Registry. registered 27th April 2017. ACTRN12617000595314. ACTRN12617000596303

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New approaches in gastrointestinal surgical oncology

Beuran¹

2018

Oncolog-Hematolog.ro

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Totally‐laparoscopic versus laparoscopic‐assisted low anterior resection for rectal cancer: are outcomes different?

Abstract: Laparoscopic-assisted low anterior resection enables minimally invasive rectal surgery to be performed despite unfavourable tumour factors and technical challenges; and compares favourably with TL approach in terms of short-term outcomes and oncological safety.

Cited by 3 publications

References 28 publications

Clinical Application of the Reverse Puncture Technique for Total Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction

Clinical Application of the Reverse Puncture Technique for Total Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction

Pentixafor as a Theranostic Agent in Rectal and Pancreatic Adenocarcinoma: Outcomes From a Pilot Study

New approaches in gastrointestinal surgical oncology

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