The impact of staple transection of the dorsal venous complex and urethra on intraoperative blood loss in cooperative laparoscopic and transperineal endoscopic pelvic exenteration.

Laparoscopic surgery Pelvic exenteration Staple transection Transperineal endoscopic surgery

Journal

Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360

Informations de publication

Date de publication:
01 May 2023
Historique:
received: 04 12 2022
accepted: 06 04 2023
medline: 2 5 2023
pubmed: 2 5 2023
entrez: 1 5 2023
Statut: aheadofprint

Résumé

While laparoscopic pelvic exenteration reduces intraoperative blood loss, dorsal venous complex bleeding during this procedure causes issues. We previously introduced a method to transect the dorsal venous complex and urethra using a linear stapler during cooperative laparoscopic and transperineal endoscopic (two-team) pelvic exenteration. The present study assessed its effectiveness in reducing intraoperative blood loss by comparing it with conventional laparoscopic pelvic exenteration. This retrospective cohort study was conducted at a Japanese tertiary referral center. Eleven cases of two-team laparoscopic pelvic exenteration with staple transection of the dorsal venous complex (T-PE group) were compared to 25 cases of conventional laparoscopic pelvic exenteration (C-PE group). The primary outcome measure was intraoperative blood loss. There were no significant between-group differences in patient background. The mean intraoperative blood loss was significantly lower in the T-PE group than in the C-PE group (200 vs. 850 mL, p = 0.01). The respective mean operation time, postoperative complication rate, and R0 resection rate were similar between the T-PE and C-PE groups (636 min vs. 688 min, p = 0.36; 36% vs. 44%, p = 0.65; 100% vs. 100%, p = 1.00). Two-team laparoscopic pelvic exenteration with staple transection of the dorsal venous complex reduced intraoperative blood loss from the dorsal venous complex in a technically safe and oncologically feasible manner.

Identifiants

pubmed: 37127776
doi: 10.1007/s00595-023-02693-x
pii: 10.1007/s00595-023-02693-x
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023. The Author(s) under exclusive licence to Springer Nature Singapore Pte Ltd.

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Auteurs

Toshiki Mukai (T)

Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan. toshiki.mukai@jfcr.or.jp.

Toshiya Nagasaki (T)

Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Takashi Akiyoshi (T)

Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Yukiharu Hiyoshi (Y)

Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Tomohiro Yamaguchi (T)

Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Hiroshi Kawachi (H)

Department of Pathology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Yosuke Fukunaga (Y)

Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-8-31 Ariake, Koto-Ku, Tokyo, 135-8550, Japan.

Classifications MeSH