Laparoscopic Colon and Rectal Resections with Intracorporeal Anastomosis and Trans-vaginal Specimen Extraction for Colorectal Cancer. A Case Series and Systematic Literature Review

Overview

Journal Int J Colorectal Dis

Specialties Gastroenterology
General Surgery

Date 2015 Mar 10

PMID 25749939

Citations 2

Authors

Francesco Stipa

Antonio Burza

Rosanna Curinga

Ettore Santini

Pietro Delle Site

Riccardo Avantifiori

Marcello Picchio

Affiliations

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Abstract

Purpose: Intracorporeal anastomosis associated to trans-vaginal specimen extraction decreases the extent of colon mobilisation and the number and size of abdominal incisions, improving the benefits of minimally invasive surgery in female patients. The aim of this study was to evaluate the safety and effectiveness of this procedure for colorectal cancer.

Methods: Between 2009 and 2013, 13 female patients underwent laparoscopic colon and rectal resection for colorectal cancer with intracorporeal anastomosis and trans-vaginal specimen extraction: 2 right colectomies, 1 transverse colon resection, 4 left colectomies and 6 anterior resections were performed. A MEDLINE search of publications on the presented procedure for colon neoplasms was carried out.

Results: There were no intraoperative complications and no conversions. Postoperative visual analogue scale (VAS) score in the pelvis, abdomen and shoulder was moderate. In the postoperative period, we observed two colorectal anastomotic strictures, successfully treated with pneumatic endoscopic dilation. Median length of the specimen was 18.5 cm, with a median tumour size of 5.5 cm in diameter. Median number of retrieved lymph nodes was 12. All circumferential resection margins were negative. During a mean follow-up of 31 months (range, 6-62), there was neither evidence of recurrent disease nor disorders related to the genitourinary system. The aesthetic outcome was considered satisfactory in all patients. Nine studies were identified in the systematic review.

Conclusions: Our case series, according to the results of the literature, showed that intracorporeal anastomosis associated to trans-vaginal specimen extraction is feasible and safe in selected female patients.

Citing Articles

Totally laparoscopic resection of right-sided colon cancer using transvaginal specimen extraction with a 10-mm-long abdominal incision.

Nishimura A, Kawahara M, Kawachi Y, Hasegawa J, Makino S, Kitami C Tech Coloproctol. 2022; 26(9):755-760.

PMID: 35604476 DOI: 10.1007/s10151-022-02636-7.

Tunicamycin inhibits colon carcinoma growth and aggressiveness via modulation of the ERK-JNK-mediated AKT/mTOR signaling pathway.

You S, Li W, Guan Y Mol Med Rep. 2018; 17(3):4203-4212.

PMID: 29344654 PMC: 5802191. DOI: 10.3892/mmr.2018.8444.

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