, Cincinnati, OH, USA). Diverting stoma was not usually performed. A pelvic drainage tube was inserted at a new stab incision at the right lower Rapamycin quadrant under laparoscopic view. In the APR cases, we started the perineal resection phase after finishing the intraperitoneal phase using the standard AP resection technique. In our hospital, cylindrical abdominoperineal resection is not routinely used. Figure 2 Splenic flexure mobilization. Figure 3 Pelvic dissection. Figure 4 Position of placed Endo articulating linear stapler. 4. Data Collection Demographic data including patients’ age, gender, and body mass index (BMI) were tabulated together with their history of prior abdominal surgery. Intraoperative parameters including operative time, estimated blood loss, and intraoperative complications were analyzed.

Pathologic characteristics such as depth invasion, lymph node retrieval, circumferential margin, distal margin, and mesorectal capsule status were reviewed, and postoperative outcomes including length of stay in hospital and complication rates were collected. 5. Results Between December, 2011 and December, 2012, 10 patients (4 females and 6 males, mean age 69 years, range 52�C86) underwent SALS for middle rectal, low rectal, and anal canal cancer. The operations comprised 9 abdominoperineal resections and 1 low anterior resection. All patients had stage II or III disease preoperatively. None received preoperative neoadjuvant therapy because they had rejected it. The average body mass index was 21.77 (range 15 to 30kg/m2) (Table 1).

In all cases, the patients’ consent for single-access laparoscopic surgery was obtained. Table 1 Demographic data. The median total surgical time was 269 minutes (range 200�C300min). The average intraoperative blood loss was 145mL (range 50�C300mL). In the LAR case, the anastomosis was 6cm from the anal verge (Table 2). Intraoperatively, there were no complications, but postoperatively, there were 6 problems: 2 cases of lung atelectasis; 2 instances of nonorganic cause delirium; 1 case of thrombophlebitis on the forearm; and 1 case of perineal wound infection. None of the patients developed neurogenic bladder (Table 3), and none of the male patients developed any sexual disorders. Table 2 Operation and pathologic result. Table 3 Postoperative details and complications. The median number of harvested lymph nodes was 15 (range 8�C30 nodes).

Postoperatively, all patients were oncologic stage II or III (4 patients were stage II, and the other 6 were stage III), and all patients received adjuvant chemoradiation therapy. Surgical margins were negative in all Carfilzomib patients, with a distal margin of at least 2cm and circumferential margin of at least 2mm in all cases (Figure 5). And the mean wound size was 5.5cm (Figure 6).