BACKGROUND: Surgical treatment for locally recurrent rectal cancer is challenging, and the value of laparoscopic surgery in such cases is unknown. The purpose of this study was to compare the feasibility of laparoscopic surgery with that of open surgery for locally recurrent rectal cancer. METHODS: Thirty patients with local rectal cancer recurrence at the anastomotic site or lateral pelvic lymph nodes were evaluated. Perioperative outcomes were compared between the laparoscopic (n = 13) and open (n = 17) groups. RESULTS: The median operation time was significantly longer (381 vs. 241 min) but the median estimated blood loss tended to be smaller (110 vs. 450 mL) in the laparoscopic than in the open group. There was only one converted case (7.7%). The R0 resection rate (100 vs. 94%) and postoperative complications (31 vs. 24%) were not significantly different between the two groups. The median times to flatus (1 vs. 2 days), first stool (2 vs. 5 days), and oral intake (2 vs. 5 days) were significantly shorter in the laparoscopic than in the open group. CONCLUSION: Laparoscopic surgery for locally recurrent rectal cancer has short-term benefits over open surgery and has potential as a treatment option for locally recurrent rectal cancer.
BACKGROUND: Surgical treatment for locally recurrent rectal cancer is challenging, and the value of laparoscopic surgery in such cases is unknown. The purpose of this study was to compare the feasibility of laparoscopic surgery with that of open surgery for locally recurrent rectal cancer. METHODS: Thirty patients with local rectal cancer recurrence at the anastomotic site or lateral pelvic lymph nodes were evaluated. Perioperative outcomes were compared between the laparoscopic (n = 13) and open (n = 17) groups. RESULTS: The median operation time was significantly longer (381 vs. 241 min) but the median estimated blood loss tended to be smaller (110 vs. 450 mL) in the laparoscopic than in the open group. There was only one converted case (7.7%). The R0 resection rate (100 vs. 94%) and postoperative complications (31 vs. 24%) were not significantly different between the two groups. The median times to flatus (1 vs. 2 days), first stool (2 vs. 5 days), and oral intake (2 vs. 5 days) were significantly shorter in the laparoscopic than in the open group. CONCLUSION: Laparoscopic surgery for locally recurrent rectal cancer has short-term benefits over open surgery and has potential as a treatment option for locally recurrent rectal cancer.
Authors: Eric J Silberfein; Kiran M Kattepogu; Chung-Yuan Hu; John M Skibber; Miguel A Rodriguez-Bigas; Barry Feig; Prajnan Das; Sunil Krishnan; Christopher Crane; Scott Kopetz; Cathy Eng; George J Chang Journal: Ann Surg Oncol Date: 2010-06-15 Impact factor: 5.344