Top

Surgical Endoscopy

Published in:

01-08-2009

Laparoscopic resection of extraperitoneal rectal cancer: a comparative analysis with open resection

Authors: In Ja Park, Gyu-Seog Choi, Kyung-Hoon Lim, Byung-Mo Kang, Soo-Han Jun

Published in: Surgical Endoscopy | Issue 8/2009

Abstract

Purpose

The aim of this study was to compare the outcomes of laparoscopic surgery with those of open resection in patients with extraperitoneal rectal cancer.

Methods

Five hundred forty-four patients with extraperitoneal rectal cancer who underwent curative resection between 1996 and 2007 were included. Patients were divided into a laparoscopic surgery group (LAP, n = 170) and an open surgery group (OPEN, n = 374).

Results

Morbidity requiring surgical correction was 5.8% in the LAP group and 4.8% in the OPEN group (p = 0.75). The anastomotic leakage rate was similar in both groups (5.7% in both; p = 0.98). Differences were found in preoperative carcinoembryonic antigen (CEA) (LAP group 4.6 ng/ml, OPEN group 7.7 ng/ml, p = 0.001), sphincter preservation (LAP group 82.9%, OPEN group 69.8%, p = 0.001), and mean distance from anal verge (LAP group 4.6 cm, OPEN group 5.2 cm, p = 0.002). Local recurrence and metastasis were similar by stage.

Conclusions

The results of this study show that laparoscopic resection of extraperitoneal rectal cancer was safe and effective.

Morino M, Parini U, Giraudo G, Salval M, ContulR Brachet, Garrone C (2003) Laparoscopic total mesorectal excision: a consecutive series of 100 patients. Ann Surg 237:335–342PubMedCrossRef

Leroy J, Jamali F, Forbes L, Smith M, Rubino F, Mutter D, Marescaux J (2004) Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc 18:281–289PubMedCrossRef

Barlehner E, Benhidjeb T, Anders S, Schicke B (2005) Laparoscopic resection for rectal cancer: outcomes in 194 patients and review of the literature. Surg Endosc 19:757–766PubMedCrossRef

Dulucq JL, Wintringer P, Stabilini C, Mahajna A (2005) Laparoscopic rectal resection with anal sphincter preservation for rectal cancer: long-term outcome. Surg Endosc 19:1468–1474PubMedCrossRef

Tsang WW, Chung CC, Kwok SY, Li MK (2006) Laparoscopic sphincter-preserving total mesorectal excision with colonic J-pouch reconstruction: five-year results. Ann Surg 243:353–358PubMedCrossRef

Hartley JE, Mehigan BJ, Qureshi AE, Duthie GS, Lee PWR, Monson JRT (2001) Total mesorectal excision: assessment of the laparoscopic approach. Dis Colon Rectum 44:315–321PubMedCrossRef

Scheidbach H, Schneider C, Konradt J, Barlehner E, Kohler L, Wittekind C, Köckerling F (2002) Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum. Surg Endosc 16:7–13PubMedCrossRef

Lopez-Kostner F, Lavery IC, Hool GR, Rybicki LA, Fazio VW (1998) Total mesorectal excision is not necessary for cancers of the upper rectum. Surgery 124:612–617PubMedCrossRef

Faerden AE, Naimy N, Wiik P, Reiertsen O, Weyessa S, Trønnes S, Andersen SN, Bakka A (2005) Total mesorectal excision for rectal cancer: difference in outcome for low and high rectal cancer. Dis Colon Rectum 48:2224–2231PubMedCrossRef

10.

Morino M, Allaix ME, Giraudo G, Corno F, Garrone C (2005) Laparoscopic versus open surgery for extraperitoneal rectal cancer: a prospective comparative study. Surg Endosc 19:1460–1467PubMedCrossRef

11.

American Joint Committee on Cancer (2001) AJCC cancer staging manual, 6th edn. Lippincott-Raven, Philadelphia

12.

Tjandra JJ, Chan MK (2006) Systematic review on the short-term outcome of laparoscopic resection for colon and rectosigmoid cancer. Colorectal Dis 8:247–258PubMedCrossRef

13.

Aziz O, Constantinides V, Tekkis PP, Athanasiou T, Purkayastha S, Parakeva P, Darzi AW, Heriot AG (2006) Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol 13:413–424PubMedCrossRef

14.

Breukink S, Pierie J, Wiggers T (2006) Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database of Systematic Reviews Issue 4. Art No.:CD005200. doi:10.1002/14651858.CD005200.pub2

15.

Nesbakken A, Nygaard K, Westerheim O, Mala T, Lunde OC (2002) Local recurrence after mesorectal excision for rectal cancer. Eur J Surg Oncol 28:126–134PubMedCrossRef

16.

Bonadeo FA, Vaccaro CA, Benati ML, Quintana GM, Garione XE, Telenta MT (2001) Rectal cancer: local recurrence after surgery without radiotherapy. Dis Colon Rectum 44:374–379PubMedCrossRef

17.

Jatzko GR, Jagoditsch M, Lisborg PH, Denk H, Klimpfinger M, Stettner HM (1999) Long-term results of radical surgery for rectal cancer: multivariate analysis of prognostic factors influencing survival and local recurrence. Eur J Surg Oncol 25:284–291PubMedCrossRef

18.

Rullier E, Sa Cunha A, Couderc P, Rullier A, Gontier R, Saric J (2003) Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer. Br J Surg 90:445–451PubMedCrossRef

19.

Vignali A, Fazio VW, Lavery IC, Milsom JW, Church JM, Hull TL, Strong SA, Oakley JR (1997) Factors associated with the occurrence of leaks in stapled rectal anastomoses: a review of 1,014 patients. J Am Coll Surg 185:105–113PubMed

20.

Karanjia ND, Corder AP, Bearn P, Heald RJ (1994) Leakage from stapled low anastomosis after total mesorectal excision for carcinoma of the rectum. Br J Surg 81:1224–1226PubMedCrossRef

21.

Rullier E, Laurent C, Garrelon JL, Michel P, Saric J, Parneix M (1998) Risk factors for anastomotic leakage after resection of rectal cancer. Br J Surg 85:355–358PubMedCrossRef

22.

Hazama S, Oka M, Suzuki T (1996) Modified technique for double stapling of colorectal anastomosis following low anterior resection. Br J Surg 83:1110PubMedCrossRef

23.

Delgado S, Momblan D, Salvador L, Bravo R, Castells A, Ibarzabal A, Pigué JM, Lacy AM (2004) Laparoscopic-assisted approach in rectal cancer patients: lessons learned from >200 patients. Surg Endosc 18:1457–1462PubMedCrossRef

24.

Scott N, Jackson P, al-Jaberi T, Dixon MF, Quirke P, Finan PJ (1995) Total mesorectal excision and local recurrence: a study of tumour spread in the mesorectum distal to rectal cancer. Br J Surg 82:1031–1033PubMedCrossRef

25.

Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC trial group (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef

26.

Cawthorn SJ, Parums DV, Gibbs NM, A_Hern RP, Caffarey SM, Broughton CI, Marks CG (1990) Extent of mesorectal spread and involvement of lateral resection margin as prognostic factors after surgery for rectal cancer. Lancet 335:1055–1059PubMedCrossRef

27.

Dixon AR, Maxwell WA, Thornton Holmes J (1991) Carcinoma of the rectum: a 10-years experience. Br J Surg 78:308–311PubMedCrossRef

28.

Enker WE, Thaler HT, Cranor ML, Polyak T (1995) Total mesorectal excision in the operative treatment of carcinoma of the rectum. J Am Coll Surg 181:335–346PubMed

29.

Heald RJ, Moran BJ, Ryall RDH, Sexton R, MacFarlane JKI (1998) The Basingstoke experience of total mesorectal excision, 1978–1997. Arch Surg 133:894–899PubMedCrossRef

Title: Laparoscopic resection of extraperitoneal rectal cancer: a comparative analysis with open resection
Authors: In Ja Park
Gyu-Seog Choi
Kyung-Hoon Lim
Byung-Mo Kang
Soo-Han Jun
Publication date: 01-08-2009
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 8/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-008-0265-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic resection of extraperitoneal rectal cancer: a comparative analysis with open resection

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2009

Novel magnetically guided intra-abdominal camera to facilitate laparoendoscopic single-site surgery: initial human experience

Analysis of patient selection and external validity in the Swedish contribution to the COLOR trial

Safety, feasibility, and short-term outcomes of laparoscopically assisted primary ileocolic resection for Crohn’s disease

Intralobar sequestration associated with cystic adenomatoid malformation: diagnostic and thoracoscopic pitfalls

Laparoscopic redo surgery for recurrent hepatocellular carcinoma in cirrhotic patients: feasibility, safety, and results

Women’s positive perception of transvaginal NOTES surgery