Laparoscopic low anterior resection for rectal carcinoma: complications and management in 132 consecutive patients.
Summary of "Laparoscopic low anterior resection for rectal carcinoma: complications and management in 132 consecutive patients."
AIM:
To analyze the clinical manifestations and risk factors of complications in laparoscopic low anterior resection (LAR) for rectal cancer patients.
METHODS:
A series of 132 consecutive patients who received laparoscopic LAR for rectal cancer in our center were included. The etiology, diagnosis, treatment and prevention of rectal cancer were studied among the patients with surgery-related complications using both univariate and multivariate regression analysis.
RESULTS:
No conversion to open surgery was observed and 5 cases converted to hand-assisted laparoscopic operation. The overall morbidity rate was 20.5%. Complications occurred during the operation in 7 patients (5.3%), within 30 postoperative days in 24 patients (18.2%), and within 3 mo in 2 patients (1.5%). The most significant complications were anastomotic leakage (9.1%) and anastomotic hemorrhage (5.3%). Size and location of tumor, pathological staging and preoperative nutrition were significant factors associated with LAR complications, while gender, age and pathological type showed no relevance. Binary logistics regression showed that the size and location of tumor, and pathological staging were independent factors of laparoscopic LAR. All the complications were treated during their onset of clinical manifestations by interventional or conservative therapy.
CONCLUSION:
Anastomotic leakage is a major complication in laparoscopic LAR. The complications may be associated with tumor size and site, and pathological stage. Interventional therapies are of value in the management of laparoscopic LAR complications.
Affiliation
Department of General Surgery, Shanghai Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
Journal Details
This article was published in the following journal.
Name: World journal of gastroenterology : WJG
ISSN: 1007-9327
Pages: 4605-10
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20857534
- DOI: http://dx.doi.org/
Medical and Biotech [MESH] Definitions
Carcinoma, Verrucous
A variant of well-differentiated epidermoid carcinoma that is most common in the oral cavity, but also occurs in the larynx, nasal cavity, esophagus, penis, anorectal region, vulva, vagina, uterine cervix, and skin, especially on the sole of the foot. Most intraoral cases occur in elderly male abusers of smokeless tobacco. The treatment is surgical resection. Radiotherapy is not indicated, as up to 30% treated with radiation become highly aggressive within six months. (Segen, Dictionary of Modern Medicine, 1992)
Intraoperative Complications
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Materials Management, Hospital
The management of all procurement, distribution, and storage of equipment and supplies, as well as logistics management including laundry, processing of reusables, etc.
Management Quality Circles
Participation of employees with management as a labor-management team, in decisions pertaining to the operational activities of the organization or industry.
Practice Management
Business management of medical and dental practices that may include capital financing, utilization management, and arrangement of capitation agreements with other parties.
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