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Open Access 01-12-2015 | Research

Hand-assisted laparoscopic surgery compared with open resection for mid and low rectal cancer: a case-matched study with long-term follow-up

Authors: Xile Zhou, Fanlong Liu, Caizhao Lin, Qihan You, Jinsong Yang, Wenbin Chen, Jiahe Xu, Jianjiang Lin, Xiangming Xu

Published in: World Journal of Surgical Oncology | Issue 1/2015

Abstract

Background

This study was designed to compare the long-term surgical outcomes of patients with mid and low rectal cancer after open or hand-assisted laparoscopic surgery (HALS).

Methods

A case-matched controlled prospective analysis of 116 patients who underwent hand-assisted laparoscopic surgery (HALS) for stage I to III mid and low rectal cancer from 2005 to 2010 was performed. Contemporary patients who underwent open rectal surgery were matched to the HALS group at the ratio of 1:1. The perioperative clinical outcomes, postoperative pathology, and survival outcomes were compared between the groups.

Results

The patient characteristics between the two groups were comparable. Ninety patients in the open group and 85 in the HALS group received sphincter-preserving surgery. HALS resulted in less blood loss and wound infection, faster return to oral diet, shorter postoperative hospital stay, and longer operating time. The two groups had similar complication rates. Lymph node retrieval and involvement of circumferential and distal margins were similar for both procedures. Cumulative incidences of locoregional recurrence, disease-free, or overall survival rates were statistically similar.

Conclusions

This study suggests that HALS for mid and low rectal cancer is acceptable in terms of short-term clinical outcomes and long-term survival results.

Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg. 2010;97(11):1638–45.PubMedCrossRef

Ng SS, Lee JF, Yiu RY, Li JC, Hon SS, Mak TW, et al. Laparoscopic-assisted versus open total mesorectal excision with anal sphincter preservation for mid and low rectal cancer: a prospective, randomized trial. Surg Endosc. 2014;28(1):297–306.PubMedCrossRef

Lujan J, Valero G, Hernandez Q, Sanchez A, Frutos MD, Parrilla P. Randomized clinical trial comparing laparoscopic and open surgery in patients with rectal cancer. Br J Surg. 2009;96(9):982–9.PubMedCrossRef

Jeong SY, Park JW, Nam BH, Kim S, Kang SB, Lim SB, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol. 2014;15(7):767–74.PubMedCrossRef

Ng SS, Leung KL, Lee JF, Yiu RY, Li JC, Teoh AY, et al. Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer: a prospective randomized trial. Ann Surg Oncol. 2008;15(9):2418–25.PubMedCrossRef

Braga M, Frasson M, Vignali A, Zuliani W, Capretti G, Di Carlo V. Laparoscopic resection in rectal cancer patients: outcome and cost-benefit analysis. Dis Colon Rectum. 2007;50(4):464–71.PubMedCrossRef

Liao G, Zhao Z, Lin S, Li R, Yuan Y, Du S, et al. Robotic-assisted versus laparoscopic colorectal surgery: a meta-analysis of four randomized controlled trials. World J Surg Oncol. 2014;12:122.PubMedCentralPubMedCrossRef

Kusminsky RE, Boland JP, Tiley EH, Deluca JA. Hand-assisted laparoscopic splenectomy. Surg Laparosc Endosc Percutan Tech. 1995;5(6):463–7.

Heneghan HM, Martin ST, Kiran RP, Khoury W, Stocchi L, Remzi FH, et al. Laparoscopic colorectal surgery for obese patients: decreased conversions with the hand-assisted technique. J Gastrointest Surg. 2013;17(3):548–54.PubMedCrossRef

10.

Aalbers AG, Biere SS, van Berge Henegouwen MI, Bemelman WA. Hand-assisted or laparoscopic-assisted approach in colorectal surgery: a systematic review and meta-analysis. Surg Endosc. 2008;22(8):1769–80.PubMedCentralPubMedCrossRef

11.

Moloo H, Haggar F, Coyle D, Hutton B, Duhaime S, Mamazza J, et al. Hand assisted laparoscopic surgery versus conventional laparoscopy for colorectal surgery. Cochrane Database Syst Rev. 2010;10:CD006585. doi:10.1002/14651858.CD006585.pub2.PubMed

12.

Tjandra JJ, Chan MK, Yeh CH. Laparoscopic- vs. hand-assisted ultralow anterior resection: a prospective study. Dis Colon Rectum. 2008;51(1):26–31.PubMedCrossRef

13.

Ozturk E, Kiran RP, Remzi F, Geisler D, Fazio V. Hand-assisted laparoscopic surgery may be a useful tool for surgeons early in the learning curve performing total abdominal colectomy. Colorectal Dis. 2010;12(3):199–205.PubMedCrossRef

14.

Ding J, Xia Y, Liao GQ, Zhang ZM, Liu S, Zhang Y, et al. Hand-assisted laparoscopic surgery versus open surgery for colorectal disease: a systematic review and meta-analysis. Am J Surg. 2014;207(1):109–19.PubMedCrossRef

15.

Aalbers AG, Doeksen A, Van Berge Henegouwen MI, Bemelman WA. Hand-assisted laparoscopic versus open approach in colorectal surgery: a systematic review. Colorectal Dis. 2010;12(4):287–95.PubMedCrossRef

16.

Cima RR, Pattana-arun J, Larson DW, Dozois EJ, Wolff BG, Pemberton JH. Experience with 969 minimal access colectomies: the role of hand-assisted laparoscopy in expanding minimally invasive surgery for complex colectomies. J Am Coll Surg. 2008;206(5):946–50.PubMedCrossRef

17.

Pendlimari R, Holubar SD, Pattan-Arun J, Larson DW, Dozois EJ, Pemberton JH, et al. Hand-assisted laparoscopic colon and rectal cancer surgery: feasibility, short-term, and oncological outcomes. Surgery. 2010;148(2):378–85.PubMedCrossRef

18.

HALS Study Group. Hand-assisted laparoscopic surgery vs standard laparoscopic surgery for colorectal disease: a prospective randomized trial. Surg Endosc. 2000;14(10):896–901.CrossRef

19.

Nakajima K, Lee SW, Cocilovo C, Foglia C, Sonoda T, Milsom JW. Laparoscopic total colectomy: hand-assisted vs standard technique. Surg Endosc. 2004;18(4):582–6.PubMedCrossRef

20.

Romanelli JR, Kelly JJ, Litwin DE. Hand-assisted laparoscopic surgery in the United States: an overview. Semin Laparosc Surg. 2001;8(2):96–103.PubMedCrossRef

21.

Zawadzki M, Velchuru VR, Albalawi SA, Park JJ, Marecik S, Prasad LM. Is hybrid robotic laparoscopic assistance the ideal approach for restorative rectal cancer dissection? Colorectal Dis. 2013;15(8):1026–32.PubMedCrossRef

22.

van der Pas MH, Haglind E, Cuesta MA, Furst A, Lacy AM, Hop WC, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013;14(3):210–8.PubMedCrossRef

23.

Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718–26.PubMedCrossRef

24.

Denost Q, Quintane L, Buscail E, Martenot M, Laurent C, Rullier E. Short- and long-term impact of body mass index on laparoscopic rectal cancer surgery. Colorectal Dis. 2013;15(4):463–9.PubMedCrossRef

25.

Zhou X, Lin C, Chen W, Lin J, Xu J. Completely diverted tube ileostomy compared with loop ileostomy for protection of low colorectal anastomosis: a pilot study. Colorectal Dis. 2014;16(9):O327–31.PubMedCrossRef

26.

Hua H, Xu J, Chen W, Zhou X, Wang J, Sheng Q, et al. Defunctioning cannula ileostomy after lower anterior resection of rectal cancer. Dis Colon Rectum. 2014;57(11):1267–74.PubMedCrossRef

27.

Bugiantella W, Rondelli F, Mariani L, Boni M, Ermili F, Avenia N, et al. Temporary percutaneous ileostomy for faecal diversion after intestinal resection for acute abdomen in elderly: how to avoid the conventional loop ileostomy. Int J Surg. 2014;12 Suppl 2:S144–7.PubMedCrossRef

28.

Anderson C, Uman G, Pigazzi A. Oncologic outcomes of laparoscopic surgery for rectal cancer: a systematic review and meta-analysis of the literature. Eur J Surg Oncol. 2008;34(10):1135–42.PubMedCrossRef

29.

Dowdall JF, McAnena OJ. Long-term results of laparoscopic vs open resections for rectal cancer in 124 unselected patients. Surg Endosc. 2005;19(2):296.PubMedCrossRef

30.

Fleshman JW, Wexner SD, Anvari M, LaTulippe JF, Birnbaum EH, Kodner IJ. Laparoscopic vs. open abdominoperineal resection for cancer. Dis Colon Rectum. 1999;42(7):930–9.PubMedCrossRef

31.

Maartense S, Dunker MS, Slors JF, Cuesta MA, Gouma DJ, van Deventer SJ, et al. Hand-assisted laparoscopic versus open restorative proctocolectomy with ileal pouch anal anastomosis: a randomized trial. Ann Surg. 2004;240(6):984–92.PubMedCentralPubMedCrossRef

Title: Hand-assisted laparoscopic surgery compared with open resection for mid and low rectal cancer: a case-matched study with long-term follow-up
Authors: Xile Zhou
Fanlong Liu
Caizhao Lin
Qihan You
Jinsong Yang
Wenbin Chen
Jiahe Xu
Jianjiang Lin
Xiangming Xu
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2015
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-015-0616-4

At a glance: The STEP trials

Springer Medicine

Hand-assisted laparoscopic surgery compared with open resection for mid and low rectal cancer: a case-matched study with long-term follow-up

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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