Clinical Feasibility and Safety of Trans-anal Specimen Extraction of High Rectal and Sigmoid Cancers

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Menoufia University Hospital, Egypt

Abstract

Introduction: There has been a growing interest in innovative minimally invasive procedures that reduce the size
of abdominal incisions to the smallest size necessary for abdominal specimen extraction. Mini-laparotomies, which
are used to retrieve specimens, have been linked to post-operative pain, wound site infections, and hernias.
Patient and methods: This prospective observational study was conducted in Menoufia University Hospital,
General Surgery Department from Jan.2018 to October 2021. A total of 20 patients were included in the study.
We aimed to evaluate the clinical feasibility and safety of trans anal specimen extraction of high rectal and sigmoid
cancers.
Results: The mean operative time was (154± 10) minutes, mean blood loss was (75 ± 10) ml, the mean time
to return to anal tone (Anal exhaustion time) was (58± 6) hours, and mean postoperative hospital stay was (5.4
± 1.3) days. The severity of the patients’ pain was determined using the Visual Analogue Scale (VAS). The patients
had a mean VAS pain score of (2.8± 0.8) after surgery. The average number of lymph nodes extracted was 16.2.
(Ranging from 12 to 18). One female patient in the trial required conversion to open laparotomy due to extensive
pelvic adhesions due PID.
Conclusion: Trans anal specimen extraction appeared to have a number of advantages, including less blood loss,
scar avoidance, and a shorter post-operative hospital stay. Trans anal specimen extraction is safe and possible in
laparoscopic anterior rectal resection for upper rectal or lower sigmoid colon cancer with certain limitations.

Keywords

Ain Shams Journal of Surgery
Volume 15, Issue 1
January 2022
Pages 50-56

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