Author/Authors :
Ghahramani، Leila نويسنده Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran , , Eghlimi، Hesameddin نويسنده Shiraz University of Medical Sciences, Shiraz, IR Iran , , Bananzadeh، AliMohammad نويسنده Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran , , Hosseini، Seyed Vahid نويسنده , , Izadpanah، Ahmad نويسنده Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran , , Safarpour، Ali Reza نويسنده Colorectal Research Center, Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran; , , Al Hurry، Ahmed Mohammed Ali نويسنده Department of Surgery, General Surgeon, Al Hussein Teaching Hospital, Kerbala, Iraq , , Muzhir Gabash، Khairallah نويسنده Department of Surgery, Al-Karama Teaching Hospital, Medical College, Wasit University, Wasit, Iraq , , Hajhosseini، Fahimeh نويسنده Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran , , Ganji، Fatemeh نويسنده Department of Stem Cells and Developmental Biology at Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran ,
Abstract :
Abdominoperineal resection (APR) along with permanent colostomy is the standard method of low rectal cancer operation and resection. The laparoscopic APR provides better visualization of pelvic structures compared to the open approach. Disadvantages of the laparoscopic approach have been reported as longer operation duration and requirement of expensive equipment Although this issue has been investigated extensively worldwide, data is limited from Iran. The aim of this study was to compare short-term outcome of Laparoscopic Abdominoperineal Resection (APR) with open APR in patients with low rectal cancer in Shiraz, southern Iran. This was a non-randomized controlled trial study performed in Shahid Faghihi Hospital affiliated to Shiraz University of Medical Sciences from 2007 to 2012. We included all patients with rectal cancer who underwent laparoscopic or open APR with permanent colostomy. Both groups were evaluated regarding oncology results. Volume of intraoperative bleeding, short-term complications, operation to diet interval and duration of hospitalization were recorded and further compared between the laparoscopy and open APR groups. Overall, 24 patients were included in this study of whom 11 underwent laparoscopy and 13 underwent open APR. The two study groups were comparable regarding age (P = 0.747), gender (P = 0.605), tumor stage (P = 0.116), tumor histopathology grade (P = 0.421) and distance from the anal verge (P = 0.711). The duration of operation was comparable between the groups (P = 0.336). Those who underwent laparoscopy had significantly lower intraoperative bleeding (485.5 ± 139.8 vs. 658.3 ± 183.2; P = 0.024), shorter operation-diet interval (2.27 ± 0.46 vs. 3.15 ± 0.37; P < 0.001) and shorter duration of hospitalization compared to the open APR group (4.09 ± 0.53 vs. 4.76 ± 0.59; P = 0.008). Laparoscopic APR is associated with minimal perioperative bleeding, shorter operation-diet interval and shorter durations of hospitalization compared to open approach in patients with low rectal cancer who had not received neoadjuvant chemo radiotherapy. Oncologic results in this operation were comprisable to open procedure because the mesorectal, anus and sphincter complex excision are performed in the same method. . Therefore, laparoscopy could be the method of choice for APR.
