Huu Phu Ly, Tat Bang Ho, Van Viet Ung, Danh Tan Hoang, Tin Nguyen Trung
Gastro-Intestinal Surgery Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM.
Thoracic and Vascular Department, University Medical Center Ho Chi Minh City, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, VNM.
Cureus. 2024 May 21;16(5):e60734. doi: 10.7759/cureus.60734. eCollection 2024 May.
Colorectal cancer is a significant health concern. Surgery remains a critical component of the multimodal treatment strategy. The laparoscopic sphincter-preserving total mesorectal excision (TME) is increasingly utilized and effective, offering enhanced quality of life for patients compared to previous traditional methods.
This study aims to determine the rate of complications and the related factors associated with complications following laparoscopic sphincter-preserving total mesorectal excision for low rectal cancer.
This retrospective study was conducted at the University Medical Center of Ho Chi Minh City from March 2022 to March 2023. It included patients aged 18 years and older diagnosed with low rectal cancer who underwent laparoscopic sphincter-preserving total mesorectal excision. Data on patient demographics, surgical details, and postoperative complications were retrospectively collected and analyzed. Follow-ups were conducted up to six months after surgery.
Of the 83 patients included, the postoperative complications rate was 14.5%. The complications observed included surgical wound infections (five cases), anastomotic leaks (five cases, including three recto-vaginal fistulas and two pelvic abscesses), urinary retention (one case), and pneumonia (one case). A significant finding was the higher rate of distant metastases in patients with complications compared to those without (p=0.033).
Laparoscopic sphincter-preserving total mesorectal excision for low rectal cancer is safe and effective, with a high success rate and low complication rate during or after surgery. Anastomotic leakage remains the most significant complication. Despite advancements in surgery, modern suturing tools, and preoperative patient optimization, complications are avoidable. Therefore, understanding the related factors and implementing preventive interventions is crucial.
结直肠癌是一个重大的健康问题。手术仍然是多模式治疗策略的关键组成部分。腹腔镜保留括约肌全直肠系膜切除术（TME）的应用越来越广泛且有效，与以往传统方法相比，能提高患者的生活质量。
本研究旨在确定低位直肠癌腹腔镜保留括约肌全直肠系膜切除术后的并发症发生率及相关因素。
本回顾性研究于2022年3月至2023年3月在胡志明市大学医学中心进行。纳入年龄18岁及以上、诊断为低位直肠癌且接受腹腔镜保留括约肌全直肠系膜切除术的患者。回顾性收集并分析患者的人口统计学数据、手术细节及术后并发症。术后随访长达6个月。
纳入的83例患者中，术后并发症发生率为14.5%。观察到的并发症包括手术伤口感染（5例）、吻合口漏（5例，包括3例直肠阴道瘘和2例盆腔脓肿）、尿潴留（1例）和肺炎（1例）。一个显著发现是，有并发症的患者远处转移率高于无并发症的患者（p = 0.033）。
低位直肠癌腹腔镜保留括约肌全直肠系膜切除术安全有效，手术期间或术后成功率高、并发症发生率低。吻合口漏仍然是最主要的并发症。尽管手术、现代缝合工具及术前患者优化方面取得了进展，但并发症仍可避免。因此，了解相关因素并实施预防干预至关重要。
