LAPAROSCOPIC ASSISTED ABDOMINOPERINEAL RESECTION OF LOW SEATED RECTAL CANCER: EVALUATION OF THE TECHNIQUE AND FUNCTIONAL OUTCOME

Document Type : Original Article

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General Surgery Department, Mansoura University, Egypt

Abstract

Aim: To assess feasibility, advantages and short term outcome of laparoscopic abdominoperineal resection 
(LAPR) for low seated rectal cancer.
Methods: From June 2008 to December 2011, 20 patients with operable low seated adenocarcinoma of the 
rectum were subjected to LAPR. Surgical technique, postoperative morbidity, clinical results and urogenital 
functions were reviewed in close follow-up for a period of 12 months.
Results: Sixty percent were males and 40 % females with mean age 52.5 years. Mean tumor size was 5.2 cm 
and the most common presentation was bleeding per rectum (80%). Mean operative time was 184.5 min, 55% 
were stage III and 45% moderately differentiated adenocarcinoma. There was 20% incidence of 
complications with perineal wound infection the commonest (15%). Both male and female patients’ sexual 
functions get markedly deteriorated postoperative and to a lesser extend urologic function. Recurrence rate 
(5%), port site and distant metastasis (0%) were recorded. 
Conclusions: LAPR is safe, feasible, meets oncologic requirements of radicality with accepted survival and 
recurrence patterns compared to open APR but at the expense of longer operative time. Also, LAPR is 
associated with worse sexual function affection in both males and females and lesser urinary function 
affection.

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