Laparoscopic total pelvic exenteration for locally advance rectal cancer. A challenging case or a gold standard procedure?
EAES Academy. Faur F. 07/05/22; 363194; P258
Dr. Flaviu Ionut Faur
Contributions
Contributions
Abstract
Abstract: Total pelvic exenteration (TPE) may be the only procedure that can cure T4 rectal cancer that directly invades the urinary bladder or prostate. Here, we describe our experience of laparoscopic TPE with en bloc lateral lymph node dissection for advanced primary rectal cancer. A 44-year-old man diagnosed with advanced lower rectal cancer (T4bN1M0) underwent laparoscopic TPE with en bloc lateral lymph node dissection after neoadjuvant chemoradiotherapy. Ligation of the dorsal vein complex was performed under direct visualization Perineoplasty was performed using a dual mesh graft in association with pediculated omentum interposition. The total operative time was and 7h and 30 min and estimated blood loss was 600 mL. Conclusion: MIS exenteration can be performed in highly selective cases, where there is favourable patient anatomy and tumour characteristics. When feasible, it is associated with reduced intra-operative blood loss, shorter length of hospital stay, and reduced morbidity. appears to be safe and feasible in selected patients.
Abstract: Total pelvic exenteration (TPE) may be the only procedure that can cure T4 rectal cancer that directly invades the urinary bladder or prostate. Here, we describe our experience of laparoscopic TPE with en bloc lateral lymph node dissection for advanced primary rectal cancer. A 44-year-old man diagnosed with advanced lower rectal cancer (T4bN1M0) underwent laparoscopic TPE with en bloc lateral lymph node dissection after neoadjuvant chemoradiotherapy. Ligation of the dorsal vein complex was performed under direct visualization Perineoplasty was performed using a dual mesh graft in association with pediculated omentum interposition. The total operative time was and 7h and 30 min and estimated blood loss was 600 mL. Conclusion: MIS exenteration can be performed in highly selective cases, where there is favourable patient anatomy and tumour characteristics. When feasible, it is associated with reduced intra-operative blood loss, shorter length of hospital stay, and reduced morbidity. appears to be safe and feasible in selected patients.
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