الفهرس | Only 14 pages are availabe for public view |
Abstract Laparoscopic total mesorectal excision (TME) for rectal cancer has been proved in various studies. The minimal invasive procedure is feasible and safe which was demonstrated in many studies. Clear advantages have been demonstrated for the laparoscopic approach in term of decreased intra-operative blood loss, faster post operative recovery & return of bowel function, decreased pain, decreased hospital stay and improved quality of life. Questions still exist about the cost and longer operating times of laparoscopic procedures. Many studies have shown that laparoscopy has a less overall cost and operating time decreases significantly with experience. For laparoscopic rectal resection in malignancy, laparoscopy is able to help surgeons reach free excision margins and harvest as many lymph nodes as would conventional surgery do. This comparable outcome is obtained by the proficiency gain curve and expertise which improves the results of laparoscopic TME and nerve sparing techniques. Few data in the literature on the functional outcome after laparoscopic TME, in our study we found that manifestations of low anterior resection syndrome occurred in almost all the patients in the early post-operative patients and these manifestations had improved with time. In our study, we had performed 40 rectal resections with no conversion to open surgery.29 of patients were males and 11 of them were females.26 of them underwent ULAR and the other 14 patients underwent intersphincteric resection. The operative time in our study ranged from 130 to 210 minutes the mean blood loss was 290 ml and no intraoperative complications like ureteric or bowel injuries were recorded. Clear advantages have been demonstrated for the laparoscopic approach in term of decreased intra-operative blood loss, faster post operative recovery & return of bowel function, decreased pain, decreased hospital stay and improved quality of life. Questions still exist about the cost and longer operating times of laparoscopic procedures. Many studies have shown that laparoscopy has a less overall cost and operating time decreases significantly with experience. |