Outcome of Tumor-specific Mesorectal Excision for Rectal Cancer: the Impact of Laparoscopic Resection

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2014 Mar 28

PMID 24671302

Citations 6

Authors

Zakir K Mohamed

Wai Lun Law

Affiliations

Soon will be listed here.

Abstract

Objective: The study aimed to compare the outcomes of laparoscopic and open resection for rectal cancer in 1,063 consecutive cases in a single center.

Methods: We performed an analysis of 11 years of experience in rectal cancer surgery and compared the outcome of laparoscopic and open surgery. Multivariate and subgroup analysis was performed to look at the effect of the level of tumor and stage of disease on short-term outcomes like conversion rate, anastomotic leak rate, length of stay, complication rate, 30-day mortality, and long-term outcomes like local recurrence and survival.

Results: A total of 1,063 patients underwent rectal resection with 470 (44.2%) patients undergoing the laparoscopic approach. Groups were comparable in terms of age, sex, or co-morbidities, and the operating time was longer in the laparoscopic group (210 vs. 150 min; p value < 0.001). A conversion rate of 6.8% was noted, with an anastomotic leak rate of 3.87% in the open group and 2.97% in the laparoscopic group. The laparoscopic group had a lower blood loss (100 vs. 350 ml; p < 0.001), lower complication rates, and shorter length of stay (6 vs. 9 days). The local recurrence rate was comparable, and the laparoscopic approach had better overall and cancer-specific survival, even after adjusting for stages. The laparoscopic approach was an independent factor associated with better overall and cancer-specific survival on multivariate analysis.

Conclusion: We confirmed the oncological safety of laparoscopic rectal cancer surgery. Laparoscopic surgery also showed superiority in the short-term and long-term outcomes of rectal cancer.

Citing Articles

Hoshino N, Fukui Y, Hida K, Obama K Ann Gastroenterol Surg. 2021; 5(2):183-193.

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The feasibility of laparoscopic TSME preserving the left colic artery and superior rectal artery for upper rectal cancer.

Zhang C, Wei H, Hu W, Sun Y, Zhang Q, Abe M World J Surg Oncol. 2020; 18(1):212.

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Comparison of early experience of robotic and transanal total mesorectal excision using propensity score matching.

Lun Law W, Foo D Surg Endosc. 2018; 33(3):757-763.

PMID: 30014329 DOI: 10.1007/s00464-018-6340-8.

Long-term outcomes and propensity score matching analysis: rectal cancer resection for patients with elevated preoperative risk.

Feng H, Schiergens T, Mao Z, Zhao J, Shen X, Lu A Oncotarget. 2016; 8(15):25679-25690.

PMID: 27974672 PMC: 5421961. DOI: 10.18632/oncotarget.13827.

Comparison of short-term and oncologic outcomes of robotic and laparoscopic resection for mid- and distal rectal cancer.

Lun Law W, Foo D Surg Endosc. 2016; 31(7):2798-2807.

PMID: 27785627 DOI: 10.1007/s00464-016-5289-8.

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