Adequate Margins for Anorectal Cancer Can Be Achieved by Single-Site Laparoscopy

Abstract

Abstract

Introduction:

To assess both the adequacy of surgical resection and the short-term postoperative outcomes for patients undergoing single-site laparoscopy (SSL) surgery involving low anterior resection (LAR) and abdominoperineal resection (APR) for malignancies.

Subjects and Methods:

Consecutive rectal and anal cancer patients who underwent SSL LAR and APR were studied. Use of neoadjuvant therapy, operative details, and 30-day complications were sought. Radial and distal margins of resection and the pathologist's evaluation of the mesorectum were analyzed.

Results:

Twelve patients (median age, 66 years) were identified; 11 (91%) were diagnosed with rectal adenocarcinoma and 1 (9%) with anal melanoma. Median location of the cancers was 5 cm from the anal verge, with 6 (55%) patients receiving neoadjuvant chemoradiation. Seven (58%) patients underwent an LAR, 2 of whom were also given a diverting ileostomy at surgery. Median body mass index was 28 kg/m² (range, 24–36 kg/m²). All resection margins were clear of tumor by histology, with the majority of patients having T3 (41%), N0 (58%) cancers. Median node yield was 18 nodes. The median distal margin was 3 cm, with a median radial margin of 6 mm. All specimens had an intact mesorectum.

Conclusions:

SSL resections for rectal and anal cancers can achieve adequate resection margins. Larger prospective studies are needed to validate oncologic outcomes for SSL.