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World Journal of Surgery

Published in:

01-08-2014

Outcome of Tumor-Specific Mesorectal Excision for Rectal Cancer: The Impact of Laparoscopic Resection

Authors: Zakir K. Mohamed, Wai Lun Law

Published in: World Journal of Surgery | Issue 8/2014

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.

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Title: Outcome of Tumor-Specific Mesorectal Excision for Rectal Cancer: The Impact of Laparoscopic Resection
Authors: Zakir K. Mohamed
Wai Lun Law
Publication date: 01-08-2014
Publisher: Springer US
Published in: World Journal of Surgery / Issue 8/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-014-2533-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Outcome of Tumor-Specific Mesorectal Excision for Rectal Cancer: The Impact of Laparoscopic Resection

Abstract

Objective

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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