Laparoscopic Sacrectomy as Part of En Bloc Resection for Locally Recurrent Rectal Cancer
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Le résumé fourni par la source
INTRODUCTION: Achieving margin-negative complete resection in locally recurrent rectal cancer often requires en bloc resection involving adjacent structures such as the sacrum. However, sacrectomy is technically demanding and poses a high risk of significant intraoperative bleeding and postoperative pelvic sepsis due to the dead space created after resection. We developed a minimally invasive surgical technique to address these challenges. TECHNIQUE: We used a laparoscopic approach to sacrectomy as part of en bloc resection for posterior locally recurrent rectal cancer. In this technique, the anterior and lateral dissection of the sacrum was performed laparoscopically, whereas the final sacral transection was performed under direct vision in the prone position. Preoperative imaging was used to identify the planned sacral transection line, which was reproduced intraoperatively using a premeasured vascular tape. Anterior and lateral dissection of the sacrum was performed laparoscopically to allow secure vascular control. Final sacral transection was performed under direct vision in the prone position. A pedicled omental flap and a dead-space-filling nonfunctional anastomosis were used to fill the pelvic cavity and prevent postoperative sepsis. A double-barreled stoma was created to facilitate fecal diversion. RESULTS: Laparoscopic sacrectomy was successfully performed in 43 patients with locally recurrent rectal cancer. The margin-negative complete resection rate was 86%, which is notably high for this challenging population. The 5-year overall survival rate was approximately 59%. No cases of major intraoperative bleeding or early complications related to the dead-space-filling nonfunctional anastomosis were observed. CONCLUSIONS: This laparoscopic technique offers a safe and feasible option for selected patients with posterior locally recurrent rectal cancer. Combined dead-space management may further help reduce postoperative complications while preserving oncological validity.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Laparoscopic Sacrectomy as Part of En Bloc Resection for Locally Recurrent Rectal Cancer
- Date Crossref
- 20/01/2026
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Osaka Gakuin University pays non établi dans la noticeUniversité ou école supérieure
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The University of Osaka pays non établi dans la noticeUniversité ou école supérieure
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Osaka International Cancer Institute Department of Gastroenterological Surgery pays non établi dans la noticeStructure de recherche
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Osaka Rosai Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Osaka National Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Hyogo Medical University pays non établi dans la noticeUniversité ou école supérieure
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Minoh City Hospital Department of Surgery pays non établi dans la noticeÉtablissement de santé
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Graduate School of Medicine Department of Gastroenterological Surgery pays non établi dans la noticeUniversité ou école supérieure
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Hyogo College of Medicine Department of Surgery pays non établi dans la noticeUniversité ou école supérieure
Osaka Gakuin University, The University of Osaka et Department of Gastroenterological Surgery — Osaka International Cancer Institute, avec 6 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.