Transvaginal extraction of the specimen after total laparoscopic right hemicolectomy or extended right hemicolectomy for right colon cancer: an analysis of 25 cases
[Objectives] To determine the clinical effectiveness of transvaginal extraction of the specimen after total laparoscopic right hemicolectomy or extended right hemicolectomy for right colon cancer. [Methods] This was a retrospective analysis of 25 patients with right colon caner treated with transvag...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | zho |
| Published: |
Editorial Office of Journal of Colorectal & Anal Surgery
2022-04-01
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| Series: | 结直肠肛门外科 |
| Subjects: | |
| Online Access: | https://jcas.gxmuyfy.cn/cn/wqll/paper.html?id=437&cateName=2022%E5%B9%B4%20%E7%AC%AC28%E5%8D%B7%20%E7%AC%AC2%E6%9C%9F |
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| Summary: | [Objectives] To determine the clinical effectiveness of transvaginal extraction of the specimen after total laparoscopic right hemicolectomy or extended right hemicolectomy for right colon cancer. [Methods] This was a retrospective analysis of 25 patients with right colon caner treated with transvaginal extraction of the specimen after total laparoscopic right hemicolectomy or extended right hemicolectomy at the First People’s Hospital of Foshan between January 2017 and January 2021. Surgical parameters, postoperative analgesic, pain at 24 hours after surgery (using Visual Analogue Scale), postoperative complications, pathological staging, adjuvant therapy, postoperative sexual function, postoperative metastasis, and recurrence were analyzed. [Results] All surgeries were uneventful. Eight patients had extended right hemicolectomy. There were no conversions to open surgery or transabdominal extraction of the specimen. There was no death during the perioperative period. The mean(SD) duration of surgery was 203.3(26.9) min. The mean(SD) intraoperative blood loss was 68.4(26.3) mL. The mean(SD) resected intestine’s length was 36.4(4.5) cm. The mean(SD) specimen’s circumferential diameter is 5.4(1.6) cm. The mean(SD) lymph node yield was 25.4(5.3). Patients received sufentanil for intravenous patient-controlled analgesia for 48 hours with no other analgesics. The mean(SD) pain score was 3.2(0.9) at 24 hours after surgery. All patients started off-bed activities 1 day after surgery. The mean(SD) time to postoperative flatulence was 3.3(0.9) days. The mean(SD) postoperative hospitalization duration was 8.2(1.8) days. Three patients had postoperative complications, including two having intestinal obstruction and one having urinary tract infection. There were no complications such as abdominal bleeding, pelvic infection, anastomotic leakage, and stoma stricture within 3 months after surgery. During the follow-up, there were no complications such as anastomotic leakage, stoma stricture, or complications related to vaginal incision. Five patients were stage Ⅰ, 11 were stage Ⅱ, and nine were stage Ⅲ. Nine patients received XELOX(capecitabine combined with oxaliplatin). Eight patients who had regular sex life pre-surgery resumed normal sex life at 3 to 6 months after surgery. The scores of the Female Sexual Function Index (FSFI) pre-surgery, 7 months, and 12 months after surgery differed significantly (P<0.05). The FSFI scores at 7 and 12 months post-surgery were higher than the FSFI score pre-surgery, and the FSFI score at 12 months post-surgery was higher than the FSFI score at 7 months post-surgery. The median follow-up was 26 months, with no loss to follow-up. There was no metastasis or recurrence. [Conclusion] Transvaginal extraction of the specimen after total laparoscopic right hemicolectomy or extended right hemicolectomy is safe and feasible with good shortterm effectiveness for right colon cancer. However, careful considerations should be given to surgical indications. |
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| ISSN: | 1674-0491 |