文档介绍：Surg Clin N Am 86 (2006) 899–914
Laparoscopic Rectal Surgery:
Rectal Cancer, Pelvic Pouch Surgery,
and Rectal Prolapse
Robert P. Akbari, MDa,b, Thomas E. Read, MDa,b,*
aDivision of Colon and Rectal Surgery, Western Pennsylvania Hospital,
4800 Friendship Avenue, Pittsburgh, PA 15224, USA
bDepartment of Surgery, Temple University School of Medicine,
Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA
Laparoscopy for rectal cancer
The adoption of laparoscopic proctectomy for rectal cancer has been
slow, primarily because of the technical difficulty of the procedure. The
wide surgeon-to-surgeon variability in disease-free survival and local pelvic
recurrence after open proctectomy probably is due to differences in surgical
technique. These differences are likely to be magnified when the challenge of
laparoscopy is added to the procedure. Oncologic and functional es
data are limited. Although the adoption of laparoscopic techniques to per-
form curative proctectomy likely will expand as technical challenges are
e and experience and training improve, the results of prospective
multicenter trials are necessary to ensure that the procedures provide equiv-
alent oncologic and functional e to conventional surgery.
Technical aspects of laparoscopic proctectomy
The technical aspects of proctectomy for adenocarcinoma of the rectum
have received considerable attention in recent years because of wide
surgeon-to-surgeon variability in local pelvic recurrence and survival rates
following curative resection [1–4]. The two monly identified sur-
geon-specific factors that are associated with good e have been
specialty training and high case volume. The technique of mesorectal mobili-
zation and resection has been demonstrated to have prognostic significance,
* Corresponding author. Department of Surgery 4600N, Western Pennsylvania Hospital,
4800 Friendship Avenue, Pittsburgh, PA 15224.
E-mail address: tread@ (. Read).