Shan Muhammad
Heilongjiang University, China
Title: Total laparoscopic middle rectal resection with transanal specimen extraction: a minimally invasive technique called NOSES
Biography:
Shan Muhammad is currently pursuing his studies in Heilongjiang University, China.
Abstract:
Objective: To evaluate the feasibility, safety and the short-term outcomes through technical aspects of the middle rectal resection followed by transanal specimen extraction.
Methods: Forty-four consecutive patients with rectal tumors underwent laparoscopic rectectomy followed by transanal specimen extraction over a period of two years. All the patients were satisfied with the inclusion criteria of this approach. Intraoperative data as well as short-term outcomes were evaluated respectively.
Results: The laparoscopic rectal resection followed by transanal specimen extraction was successfully carried out in all of the 44 patients without intraoperative conversion and additional access. The mean operation time was 182.7 min (range 130-255 min), the mean blood loss was 26.5 ml (range 5-120 ml), the mean postoperative exhaust time was 31.3 hours (range 16-60 hours), and the mean length of hospital stay was 9.5 days (range 8-19 days). One of the patients was detected with an anastomotic leakage postoperatively which was dealt with an antibiotic course and daily pelvic cavity flush. No infection-related complications and anal incontinence were observed. The mean size of the tumor was 2.1 cm (range from 1.6-3.2 cm), the mean number of harvested lymph nodes was 16.5 (range 6-31) and the mean follow-up time was 8.5 months (range 2-16 months). To the last follow-up, no signs of recurrence in any of these patients were found.
Conclusion: The combination of standard laparoscopic rectectomy and transanal specimen extraction could be a well-established strategy and may be considered as an alternative procedure to the conventional laparoscopic rectectomy.