Laparoscopic total mesorectal excision for rectal cancer

Objective To evaluate the application of laparoscopic surgery for total mesorectal excision (TME). Methods Thirty nine cases with rectal cancer underwent laparoscopic total mesorectal excision from July 1999 to November 2001.The patients were registered and followed up. Results Thirty cases received laparoscopic anterior rectectomy,one patient required open operation finally, and 9 laparoscopic assisted Miles operation.No patient died of operation, only one patient suffered from bleeding of venous plexus of pelvic cavity (2 56%). The mean operative time was 185 min, the mean blood loss was 85 ml, and the mean postoperative hospital stay was 8 5 days.One patient was complicated with anastomosis fistula and another uroschesis after the operation. All the patients were followed up from 1 to 28 months. Local pelvic recurrence was found in one patient after 12 months, who was in Dukes C1 stage with poorly differentiated adenocarcinoma. No implantation was found in the trocar holes and the incisions of abdominal wall in the all patients. Conclusion Laparoscopic total mesorectal excision, with less surgical trauma, less postoperative pain and rapid recovery, is both feasible and safe, which should be performed by a skilled surgeon.