The comparative analysis of results of an anterior and lower anterior resection at rectal malignant tumors
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Abstract
The objective: the assessment of expediency of use of laparoscopic technologies in performing total mesorectal excision (TME) concerning rectal cancer and increase in efficiency of treatment and quality of life in patients with rectal cancer by improvement of the direct and remote results of the surgical and combined treatment due to performance of TME.
Patients and methods. There were 103 patients under observation with the established diagnosis «rectal cancer». Patients were divided into 2 groups: patients to whom TME was performed by a laparoscopic method, (n=47) and patients to whom TME was performed by an open way (n=56). Depending on quality of TME, investigated distributed on 3 subgroups: 1) good (grade 3), 2) satisfactory (grade 2), unsatisfactory (grade 1).
Results. According to our observations, quality of TME, i.e. conservation of a mesorectal fascia, depends on localization of tumor in relation to a rectal sphincter and on a tumor stage. Correctly performed TME (both laparoscopic, and open) is the main method of treatment preventing development of a local recidive. At poorly performed TME the probability of a local recidive makes 16,7% (for open method) and 11,1% (for laparoscopic method)
Conclusion. High quality of performance of TME sufficiently reduces risk of emergence of a local recidives. At low located tumors in T3 stage, and particularly in T4, in connection with decline in quality of TME it is recommended to give preference to an open method of an operative measure. In other cases there is no basic difference between quality of TME at a laparoscopic and open method.
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