Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer: A 9-year review

doi:10.4240/wjgs.v16.i3.777

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Surg. Mar 27, 2024; 16(3): 777-789
Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.777

Table 2 Intra-operative characteristics of patients who underwent multivisceral resection, n (%)

	Total (n = 46)	Minimally invasive (n = 34)	Open (n = 12)	P value
Surgical access				N/A
Laparoscopic	13 (28.3)	13 (38.2)	-
Robotic	21 (45.7)	21 (61.8)	-
Urgency of surgery				0.015^a
Elective	44 (95.7)	34 (100)	10 (83.3)
Emergency	2 (4.3)	0 (0)	2 (16.7)
Type of surgery				0.147
ULAR with DI	30 (65.2)	25 (73.5)	5 (41.7)
APR	11 (23.9)	6 (17.6)	5 (41.7)
Hartmann’s procedure	3 (6.5)	2 (5.9)	1 (8.3)
LAR	1 (2.2)	0 (0)	1 (8.3)
taTME	1 (2.2)	1 (2.9)	0 (0)
Extent of resection				-
En-bloc seminal vesicles	5 (10.9)	5 (14.7)	0 (0)
Posterior vaginectomy	4 (8.7)	4 (11.8)	0 (0)
Salpingo-oopherectomy	1 (2.2)	1 (2.9)	0 (0)
Bladder sparing prostatectomy	5 (10.9)	4 (11.8)	1 (8.3)
Posterior exanteration	22 (47.8)	16 (47.1)	6 (50.0)
Total pelvic exanteration	9 (19.6)	4 (11.8)	5 (41.7)
Small bowel resection	1 (2.2)	1 (2.9)	0 (0)
Sacrectomy	3 (6.5)	0 (0)	3 (25.0)
Initial stoma creation	35 (76.1)	27 (79.4)	7 (58.3)	0.153
Eventual reversal	18 (51.4)	15 (55.6)	3 (42.9)
Intra-operative ureteric injury	2 (4.3)	2 (5.9)	0 (0)	0.390
Operating time, min	562 (225-900)	566.5 (275-900)	502.5 (225-751)	0.150
Estimated blood loss, mL	500 (0-4000)	450 (0-2400)	1200 (200-4000)	0.008^a
Pathological TNM stage				0.836
Complete pathological response	1 (2.2)	1 (2.9)	0 (0)
1	1 (2.2)	1 (2.9)	0 (0)
2	20 (43.5)	15 (44.1)	5 (41.7)
3	17 (37.0)	11 (32.4)	6 (50.0)
4	7 (15.2)	6 (17.6)	1 (8.3)
R0 resection	37 (80.4)	27 (79.4)	10 (83.3)	0.768

^aP < 0.05. Values indicate statistical significance, where P < 0.05.

All continuous variables were expressed as median (range) unless specified. All categorical variables were expressed as n (%) unless otherwise specified. APR: Abdominoperineal resection; DI: Defunctioning ileostomy; N/A: Not applicable; LAR: Low anterior resection; taTME: Transanal total mesorectal excision; TNM: Tumour, Node, Metastasis; ULAR: Ultra-low anterior resection.

Citation: Chan KS, Liu B, Tan MNA, How KY, Wong KY. Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer: A 9-year review. World J Gastrointest Surg 2024; 16(3): 777-789
URL: https://www.wjgnet.com/1948-9366/full/v16/i3/777.htm
DOI: https://dx.doi.org/10.4240/wjgs.v16.i3.777