EP414 - Minimally invasive TPE: operative and oncological outcomes

ePoster Presenter(s)

• 

  Ankit Sharma, MS, MCh. Surgical Oncology (he/him/his)

  Assistant Professor
  Colorectal Division, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai
  Tata Memorial Hospital, Mumbai
  Mumbai, Maharashtra, India

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

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Author(s)

• RK

  Raj Kapadia, MS, MCh. Surgical Oncology

  Assistant Professor
  Colorectal Division, Department of Surgical Oncology, Tata Memorial Hospital, Mumbai
  Mumbai, Maharashtra, India

  Disclosure information not submitted.
• MK

  Mufaddal Kazi, MS; M.Ch

  Associate Professor
  TATA MEMORIAL CENTRE, MUMBAI
  mumbai, Maharashtra, India

  Disclosure information not submitted.
• AD

  Ashwin Desouza, MCh, MS, MRCSEd, DNB, FCPS, MNAMS

  Professor & Surgeon
  Tata Memorial Centre and homi BhaBha National Institute, Mumbai.
  Mumbai, Maharashtra, India

  Disclosure information not submitted.

Senior Author(s)

• 

  Avanish P. Saklani, FRCS

  Professir Robotic / colorectal
  Tata Memorial Hospital ,
  Tata Memorial hospital , Mumbai
  Mumbai, Maharashtra, India

  All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

Purpose/Background: Despite advancement in neo-adjuvant therapy, there are some patients that require multi-visceral beyond-TME procedures. Such procedures are associated with significant morbidity. Minimally invasive techniques can help reduce this morbidity. There is limited data regarding use of MIS for T4 lesions. We wish to present our experience of MIS exenteration for LARC.

Methods/Interventions: All consecutive patients undergoing beyond-TME procedures were retrospectively analysed between 2013-2025. Baseline demographic, clinico-aptological details, neoadjuvant regimens, short term surgical outcomes and survival data were documented.

Results/Outcomes: 450 exenterations were performed of which 218 were done via MIS approach (163 laparoscopic and 55 robotic). 70% of the patients were males with a median age of 47 years. PDAC accounted for 32.2% of the lesions and 16 patients (9.2%) were oligometastatic at presentation. 96% of the patients received neoadjuvant radiation while 63% of the patients received chemotherapy prior to surgery. Bone resections were performed in 7.3% of the cases and 64.2% of the patients underwent pelvic lymph node dissection. Urinary reconstruction was performed with an ileal conduit in 96% of our patients with a leak rate of 15.4%.

CRM involvement was noted in 5.3% of the patients and 74% completed adjuvant therapy. Median hospital stay was 11 days and grade III complications were observed in 28%. Post op mortality rate was 2% in our cohort. The 2 yr OS and DFS were 77.6% and 59.5% respectively.

Conclusion/Discussion: Minimally invasive exenterations for LARC are technically feasible and safe.

MIS TPE: Operative and oncological outcomes
MIS TPE specimen