COMPARATIVE ANALYSIS OF CIRCUMFERENTIAL RESECTION MARGIN CONDITION DURING THE LAPAROSCOPIC AND OPEN TOTAL MESORECTAL EXCISION

Authors:

Abstract:

The research work was carried out under the examination and treatment of 103 patients diagnosed with rectal carcinoma. The patients were divided into 2 semi-groups: 47 patients implemented total mesorectal excision in a laparoscopic way; 56 patients implemented total mesorectal excision in an open way. MRT examination of the small pelvis, CT examination of the chest cavity and abdominal cavity, colonoscopy, appointment of the oncomarkers in blood and other methods of examination were used in the course of the research. The factors like the tumor size, invasion depth, metastatic damage of the mesorectal lymph nodes, tumor emboles, tumor deposits, distance from the anus, phase of the tumor process and quality of the total mesorectal excision have statistical exact effect on the circumferential resection margin status during the pathohistological examination of the drug made. The circumferential resection margin was positive in T3/T4 masses in 66.7 % cases, in the patients with their lymph nodes damaged metastatically in 57.1 % cases, in the tumors of III phase in 57.1 % cases, in large tumors more than 4cm in 50 % cases. 33.3 % local recurrence was noted in these patients (p<0.05).

Keywords:

Rectal carcinoma circumferential resection margin total mesorectal excision tumor embolus tumor deposits metastatic lymph nodes

References:

1. Dauletbayev DA, Kaliaskarov ESh, Menyakov MT, Serikov NS, Aubakirov EA. Sovremennye aspekty khirurgicheskogo lecheniya kolorektalnogo raka. Bulletin of KazNMU. 2016; 1: 226-229. DOI:10.17116/hirurgia2018376-81 [In Russian]
2. Medvednikov AA, Shelekhov AV, Plyonkin SM, Zaharov AG, Popova NV, Reva AA. Sravnitelnyi analiz rezultatov khirurgicheskogo lecheniya raka sredne-i nizhneampulyarnogo otdelov pryamoy kishki. Sibirskiy meditsinskiy zhurnal (Irkutsk). 2014; 7: 53-54. DOI: 10.17650/2220-3478-2015-5-2-27-35. [In Russian]
3. Rasulov AO, Mamedli ZZ, Kulushev VM. Laparoskopicheskaya intersfinkternaya bryushno-analnaya rezektsiya pryamoy kishki po povodu nizhneampulyarnogo raka s transanalnym udaleniem preparata, formirovaniem tolstokishechnogo J-obraznogo rezervuara i koloanalnogo anastomoza. Endoskopicheskaya khirurgiya. 2014; 20(1): 42–7. [In Russian]
4. Chernikovskiy IL. Sravnitelnyi analiz laparoskopicheskikh nizkikh rezektsiy pryamoy kishki. Onkologicheskaya roloproktologiya. 2015; 2: 27-35. DOI: 10.17650/2220-3478-2015-5-2-27-35. [In Russian]
5. Shchepotin IB, Kolesnik EA, Priymak VV. Evolyutsiya sfinkter-sokhranyayushchey khirurgii u bolnykh rakom nizhneampulyarnogo otdela pryamoy kishki. Klinicheskaya onkologiya. 2013; 4: 16–20. [In Russian]
6. Azimov AH. The comparative analysis of the remote results at the patients whom has been carried out a total mesorectal excision conserning malignant tumors of a rectum. East European Scientific Journal. 2017; 12(28): 42–47 DOI: 10.31618/EESA.2782-1994
7. Green B, Marshall H, Collinson F. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. Br J Surg. 2013; 100(1): 75–82. doi: 10.1002/bjs.8945
8. Jeong SY, Park JW, Nam BH, Kim S, Kang SB, Lim SB, Choi HS, Kim DW, et al. Open ver­sus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradio­therapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15(7): 767–74. doi: 10.1016/S1470-2045(14)70205-0. PMID: 24837215.
9. Kyrian OA. Search for diagnostic relationships in patients with irritable bowel syndrome and colorectal polyps. Svіt medicini ta bіologії. 2021; 1 (75): 74–78. Doi:10.26724/2079-8334-2021-1-75-74-78
10. Rubin F, Douard R, Wind P. The func­tional outcomes of coloanal and low colorectal anastomoses with reservoirs after low rectal cancer resections. Am Surg 2014; 80(12): 1222–9. PMID: 25513921.
11. Shiomi A, Ito M, Maeda K, Kinugasa Y, Ota M, Yamaue H, et al. Effects of a diverting stoma on symptomatic anasto­motic leakage after low anterior resection for rectal cancer: a propensity score matching analysis of 1,014 consecutive patients. J Am Coll Surg. 2015; 220(2): 186–94. doi: 10.1016/j.jamcollsurg.2014.10.017. Epub 2014 Nov 4. PMID: 25529899.
12. Van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term out­comes of a randomised, phase 3 trial. Lancet Oncol 2013;14(3):210–8. doi: 10.1016/S1470-2045(13)70016-0. Epub 2013 Feb 6. PMID: 23395398.

Publication:

«World of Medicine and Biology» Vol. 18 No. 80 (2022) , с. 7-12
УДК 616-006; 616-089

DOI:

https://doi.org/10.26724/2079-8334-2022-2-80-7-12