Original Article


Laparoscopic modify extralevator abdominoperineal resection for rectal carcinoma in the prone position

Kai Ye, Jianan Lin, Yafeng Sun, Yiyang Wu, Jianhua Xu

Abstract

Background: Laparoscopic technique applying for low rectal Carcinoma excision and the extralevator technique applying for abdominoperineal resection are involved with emerging technologies. The aim of this study was to introduce a modified approach of a direct visible resection: the levator muscles with laparoscopic technique and the alteration of patient’s position to a PJK position for the perineal resection of T3–T4 low rectal carcinoma.
Methods: A 54-year-old woman with rectal carcinoma within 4 cm of the anal verge, the pathology confirmed adenocarcinoma. The enteroscopy showed that a cauliflower-like carcinoma was seen in the back of rectum. MRI and ERUS showed that the carcinoma of the lower rectum infiltrate muscular rand no enlarged lymph node around the rectum be noted. Preoperative TNM-staging was T3NxM0, and the patient was underwent an modified approach of a direct visible resection: the laparoscopic technique and the alteration to PJK position.
Results: The operation cost 180 min with bleeding of about 50 mL. The patient recovers well postoperation and discharged from hospital on the 7th day.
Conclusions: Laparoscopic modify extralevator abdominoperineal excision (ELAPE) for rectal carcinoma can be safely performed without the occurrence of short-term complications.

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