[Laparoscopic abdominoperineal resection of rectum. Analysis of 18 cases]. 1998

A H Sousa Júnior, and A Habr-Gama, and F G Campos, and S E Araujo
Departamento de Gastroenterologia, Faculdade de Medicina, Universidade de São Paulo.

Laparoscopic abdominoperineal resection (APR-L) represents a truly laparoscopic operation which feasibility has been demonstrated by several authors. The wish to offer a minimally invasive procedure to patients that will deal with permanent colostomy was responsible for the authors' initial experience with the method which began in 1992. Hospital charts of patients who underwent APR-L to this date were reviewed and data regarding duration of the operation, intraoperative complications, need for conversion and characteristics of the postoperative period were assessed. Seventeen patients with the diagnosis of adenocarcinoma of the low rectum and one with squamous carcinoma of the anal canal underwent APR-L in a selective basis. The duration of the procedure was between two and six hours. There were no intraoperative complications. There was one conversion due to a large uterus that impaired pelvic dissection. One patient underwent laparotomy in the postoperative course as result of abdominal distension and incipient pelvic herniation of a small bowel wall through perineal wound. There were no septic complications and mean hospital stay was seven days. Perineal hernia occurring in the late postoperative period was seen in two patients. One of these underwent surgical correction through a conventional approach. Authors conclude that APR-L is feasible with low morbidity. Rectal oncologic dissection through video-laparoscopic access seems to be preserved and the method seems to be superior to the conventional access when considering that there is no need for abdominal incision.

UI MeSH Term Description Entries
D007431 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. Peroperative Complications,Surgical Injuries,Complication, Intraoperative,Complication, Peroperative,Injuries, Surgical,Complications, Intraoperative,Complications, Peroperative,Injury, Surgical,Intraoperative Complication,Peroperative Complication,Surgical Injury
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D012004 Rectal Neoplasms Tumors or cancer of the RECTUM. Cancer of Rectum,Rectal Cancer,Rectal Tumors,Cancer of the Rectum,Neoplasms, Rectal,Rectum Cancer,Rectum Neoplasms,Cancer, Rectal,Cancer, Rectum,Neoplasm, Rectal,Neoplasm, Rectum,Rectal Cancers,Rectal Neoplasm,Rectal Tumor,Rectum Cancers,Rectum Neoplasm,Tumor, Rectal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000230 Adenocarcinoma A malignant epithelial tumor with a glandular organization. Adenocarcinoma, Basal Cell,Adenocarcinoma, Granular Cell,Adenocarcinoma, Oxyphilic,Adenocarcinoma, Tubular,Adenoma, Malignant,Carcinoma, Cribriform,Carcinoma, Granular Cell,Carcinoma, Tubular,Adenocarcinomas,Adenocarcinomas, Basal Cell,Adenocarcinomas, Granular Cell,Adenocarcinomas, Oxyphilic,Adenocarcinomas, Tubular,Adenomas, Malignant,Basal Cell Adenocarcinoma,Basal Cell Adenocarcinomas,Carcinomas, Cribriform,Carcinomas, Granular Cell,Carcinomas, Tubular,Cribriform Carcinoma,Cribriform Carcinomas,Granular Cell Adenocarcinoma,Granular Cell Adenocarcinomas,Granular Cell Carcinoma,Granular Cell Carcinomas,Malignant Adenoma,Malignant Adenomas,Oxyphilic Adenocarcinoma,Oxyphilic Adenocarcinomas,Tubular Adenocarcinoma,Tubular Adenocarcinomas,Tubular Carcinoma,Tubular Carcinomas
D013529 Surgical Wound Dehiscence Pathologic process consisting of a partial or complete disruption of the layers of a surgical wound. Dehiscence, Surgical Wound,Wound Dehiscence, Surgical

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