SRS80 - Outcomes after laparoscopic abdominoperineal resection—a five year analysis

Abstract Aims Low rectal adenocarcinoma requiring abdomino perineal resection (APR) need a tailormade approach depending on the stage and involvement of the levator muscle complex. Laparoscopic technique along with total mesorectal excision (TME) is now the standard of care. Our aim was to evaluate the patient related, surgical and oncological outcomes of the procedure. Methods Prospective data of all patients who underwent laparoscopic APR over 5 years from 2018 to 2022 . Primary outcome was the quality of TME. Secondary outcomes were local or systemic recurrence, distant metastasis, mortality, early and late complications. Results 71 patients underwent standard APR with TME. 14 patients (20%) had polyp cancer and rest were ulceroproliferative tumours. TME quality of Grade 3 in 95% of cases. 10 patients were performed via open after diagnostic laparoscopy. 6 out of the remaining 61 patients needed open conversion after starting laparoscopic approach due to difficulty/nonprogression via laparoscopic approach. The resection margin was clear in 94% and 4 patients (6%) had R1 margins. 2 patients had return to theatre for bowel obstruction in immediate 10 day postoperative period. There was no mortality within the 30 day period. 5 cases had readmission for stoma or surgical site related complication in a 6 month period. 1 patient with R0 resection had local recurrence while 11 patients were noted to have distant metastases on 5 year follow up. Conclusions Our analysis shows overall excellent outcomes in patients who had laparoscopic abdominoperineal resection as confirmed by published literature.