BACKGROUND: This study aimed to prospectively evaluate operative safety and mid-term oncologic outcomes of laparoscopic rectal cancer resection performed by a single surgeon. METHODS: Three hundreds twelve patients (male, 181) were enrolled in this analysis. 257 patients (82.4%) had tumors located below 12 cm from the anal verge. Distribution of TNM stages was 0:I:II:III:IV = 4.2%:17.9%:32.4%:37.2%:8.3%. 225 patients (71.1%) had T3/T4 lesions. Pre- and post-operative radiation was given in 6 and 20 patients, respectively. RESULTS: Sphincter-preserving operation was performed in 85.9%. Mean operating time was 212 minutes. Conversion rate was 2.6%. Overall morbidity rate was 21.1%. Anastomotic leakage occurred in 6.4%. Operative mortality rate was 0.3%. Mean number of harvested nodes was 23. Mean distal tumor-free margin was 2.8 cm. The circumferential resection margin was positive in 13 patients (4.2%). With a mean follow-up of 30 months in the stage I-III patients, the local recurrence rate was 2.9%. Systemic recurrence occurred in 11.7%. No port-site recurrence was observed. CONCLUSION: Laparoscopic resection of rectal cancer provided safe operative parameters and adequate mid-term oncologic outcomes. When considering a high volume of advanced and low-lying cancers but rather narrow indication to radiotherapy, the 2.9% local recurrence rate seems promising data. Long-term follow-up is mandatory to draw conclusion.
BACKGROUND: This study aimed to prospectively evaluate operative safety and mid-term oncologic outcomes of laparoscopic rectal cancer resection performed by a single surgeon. METHODS: Three hundreds twelve patients (male, 181) were enrolled in this analysis. 257 patients (82.4%) had tumors located below 12 cm from the anal verge. Distribution of TNM stages was 0:I:II:III:IV = 4.2%:17.9%:32.4%:37.2%:8.3%. 225 patients (71.1%) had T3/T4 lesions. Pre- and post-operative radiation was given in 6 and 20 patients, respectively. RESULTS: Sphincter-preserving operation was performed in 85.9%. Mean operating time was 212 minutes. Conversion rate was 2.6%. Overall morbidity rate was 21.1%. Anastomotic leakage occurred in 6.4%. Operative mortality rate was 0.3%. Mean number of harvested nodes was 23. Mean distal tumor-free margin was 2.8 cm. The circumferential resection margin was positive in 13 patients (4.2%). With a mean follow-up of 30 months in the stage I-III patients, the local recurrence rate was 2.9%. Systemic recurrence occurred in 11.7%. No port-site recurrence was observed. CONCLUSION: Laparoscopic resection of rectal cancer provided safe operative parameters and adequate mid-term oncologic outcomes. When considering a high volume of advanced and low-lying cancers but rather narrow indication to radiotherapy, the 2.9% local recurrence rate seems promising data. Long-term follow-up is mandatory to draw conclusion.
Authors: S Delgado; D Momblán; L Salvador; R Bravo; A Castells; A Ibarzabal; J M Piqué; A M Lacy Journal: Surg Endosc Date: 2004-08-26 Impact factor: 4.584
Authors: Pierre J Guillou; Philip Quirke; Helen Thorpe; Joanne Walker; David G Jayne; Adrian M H Smith; Richard M Heath; Julia M Brown Journal: Lancet Date: 2005 May 14-20 Impact factor: 79.321
Authors: Ka Lau Leung; Samuel P Y Kwok; Steve C W Lam; Janet F Y Lee; Raymond Y C Yiu; Simon S M Ng; Paul B S Lai; Wan Yee Lau Journal: Lancet Date: 2004-04-10 Impact factor: 79.321
Authors: Heidi Nelson; Daniel J Sargent; H Sam Wieand; James Fleshman; Mehran Anvari; Steven J Stryker; Robert W Beart; Michael Hellinger; Richard Flanagan; Walter Peters; David Ota Journal: N Engl J Med Date: 2004-05-13 Impact factor: 91.245