KỸ THUẬT CẮT TẦNG SINH MÔN NGOÀI CƠ NÂNG Ở TƯ THẾ NẰM SẤP TRONG ĐIỀU TRỊ UNG THƯ TRỰC TRÀNG THẤP

Abstract

Background: Laparoscopic abdominoperineal rectal resection outside the levator muscle to treat low rectal cancer has limited the rate of tumor rupture and the rate of circumferential resection area (+) and thereby has reduced risk of local recurrence and distant metastasis. Objectives: Evaluate the surgical technique and short-term results of laparoscopic rectal resection of the perineum outside the levator muscle in the prone position in the treatment of low rectal cancer. Objectives and methods: The patients had low rectal cancer in stages I, II, III and underwent lAPE in the prone position in Can Tho from May 2019 to May 2023. Propective study on: age, gender, tumor characteristics. Oncology results: histopathology, lymph nodes, stage of disease, CRM status. Surgical results: operation time, intraoperative complications, postoperative complications. Results: The mean distance of the lower umferential resection margins (CRM) (+) from 49.6% to 20.3%, and the intraoperative perforation (IOP) rate from 28.2% to 8.2 margin of the tumor from the anal margin 1.6cm. The mean age in the study group was 68 years. CRM (+) accounted for 28.9%, average harvested of 16.7 lymph nodes, mean metastasis of 1.6 lymph nodes, grade T3 accounted for the majority with 68.9%, intraoperative perforation 0%, Postoperative complications commonly occurred in perineal wound with 17.8%. The average perineal resection time was 73 minutes. Conclusion: laparoscopic extra-levator abdomino-perineal excision, we found that there are many advantages in perineal dissection to reduce the rate of intraoperation perforation, perineal wound is not serious. However, the rate of CRM (+) was found to be related to the grade T of the tumor