Is the laparoscopic approach for rectal cancer superior to open surgery? A systematic review and meta-analysis on short-term surgical outcomes.

Małczak, Piotr; Mizera, Magdalena; Torbicz, Grzegorz; Witowski, Jan; Major, Piotr; Pisarska, Magdalena; Wysocki, Michał; Strzałka, Marcin; Budzyński, Andrzej; Pędziwiatr, Michał

doi:10.5114/wiitm.2018.75845

Cited by 21 publications

(19 citation statements)

References 37 publications

(49 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Laparoscopic surgery is an approved technique in colorectal cancer treatment. Lower rates of perioperative complications and at least equal oncological results have been proven in randomised controlled trials and confirmed with meta-analyses [ 1 , 2 ]. Despite technical improvements to abdominoperineal resection [ 3 ], over the last two decades there has been a significant shift in types of resections performed for rectal cancer treatment [ 4 ].…”

Section: Introductionmentioning

confidence: 83%

Defunctioning ileostomy and mechanical bowel preparation may contribute to development of low anterior resection syndrome.

Nowakowski

Rubinkiewicz

Gajewska

et al. 2018

Videosurgery and Other Miniinvasive Techniques

Self Cite

View full text Add to dashboard Cite

IntroductionLaparoscopic surgery is an approved technique in colorectal cancer treatment. Functional and quality-of-life studies have revealed significant changes in faecal continence.AimTo assess the incidence and risk factors of low anterior resection syndrome (LARS) in patients undergoing rectal resections for cancer.Material and methodsWe enrolled patients undergoing rectal resections in a general surgery department of a university hospital. The primary outcomes were the Jorge-Wexner scale and the LARS score 6 months after the end of treatment. The secondary outcomes were the risk factors for LARS development.ResultsFifty-six patients were included; 15 (26%) developed major LARS and 10 (18%) had minor LARS at 6 months. In univariate analysis the risk factors were: preoperative radiotherapy (p < 0.001, OR = 11.9, 95% CI: 2.98–47.48); shorter distance of the tumour from the anal verge (p = 0.001, OR = 0.69, 95% CI: 0.55–0.86); bowel preparation (p = 0.01, OR = 6.27, 95% CI: 1.51–26.07); low anterior rectal resection (p = 0.01, OR = 17.07, 95% CI: 1.86–156.83); and protective ileostomy (p = 0.001, OR = 15.97, 95% CI: 4.07–61.92). The risk factors for a higher Jorge-Wexner score in univariate analysis were greater diameter of tumour (p = 0.035), radiotherapy (p = 0.001), shorter distance from the anal verge (p = 0.002), bowel preparation (p = 0.042), low anterior rectal (LAR) (p = 0.01), ileostomy (p = 0.001), perioperative complications (p = 0.032), and readmission within 30 days (p = 0.034). In the multivariate analysis, readmissions and perioperative complications were significant.ConclusionsIn addition to typically described risk factors, two new ones have been identified. Mechanical bowel preparation and defunctioning ileostomy may also contribute to LARS development. However, due to the limitations of this study our observations require further confirmation in future trials.

show abstract

Section: Introductionmentioning

confidence: 83%

Defunctioning ileostomy and mechanical bowel preparation may contribute to development of low anterior resection syndrome.

Nowakowski

Rubinkiewicz

Gajewska

et al. 2018

Videosurgery and Other Miniinvasive Techniques

Self Cite

View full text Add to dashboard Cite

show abstract

“…Colorectal cancer (CRC) is the third most common cancer and the fourth most common cause of cancer‐related deaths worldwide . About athird of all large bowel cancers originate in the rectum, and are the most common malignant tumors in younger individuals .…”

Section: Introductionmentioning

confidence: 99%

Chrysophanol exhibits inhibitory activities against colorectal cancer by targeting decorin

Deng

Xue

et al. 2019

Cell Biochemistry & Function

View full text Add to dashboard Cite

Colorectal cancer (CRC) is a common human malignancy that accounts for 600,000 deaths annually worldwide. Chrysophanol, a naturally occurring anthraquinone compound, exhibits anti-neoplastic effects in various cancer cells. The aim of this study was to explore the biological effects of chrysophanol on CRC cells, and determine the underlying mechanism. Chrysophanol inhibited proliferation of and promoted apoptosis in CRC cells by activating the intrinsic mitochondrial apoptotic pathway.In addition, chrysophanol also suppressed tumor growth in vivo and increased the percentage of apoptotic cells in tumor xenografts, without general toxicity. Proteomic iTRAQ analysis revealed decorin (DCN) as the major target of chrysophanol. DCN was upregulated in the tumor tissues following chrysophanol treatment, and ectopic DCN expression markedly augmented the pro-apoptotic effects of chrysophanol in CRC cells. In contrast, DCN knockdown significantly abrogated chrysophanolinduced apoptosis in CRC cells. Taken together, chrysophanol exerts anti-neoplastic effects in vitro and in vivo in CRC cells by modulating DCN, there by highlighting its therapeutic potential in CRC.

show abstract

“…This result is comparable to those found in the literature that show that laparoscopic rectal surgeries present a shorter hospitalization period compared to open surgeries. [ 1 , 2 , 4 , 7 , 9 , 11 – 14 , 21 , 24 ]…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic vs open colorectal surgery

Ribeiro

Tayar

Ribeiro³

et al. 2020

Medicine

View full text Add to dashboard Cite

Laparoscopic surgery has become the preferred surgical approach of several colorectal conditions. However, the economic results of this are quite controversial. The degree of adoption of laparoscopic technology, as well as the aptitude of the surgeons, can have an influence not only in the clinical outcomes but also in the total procedure cost. The aim of this study was to evaluate the clinical and economic outcomes of laparoscopic colorectal surgeries, compared to open procedures in Brazil. All patients who underwent elective colorectal surgeries between January 2012 and December 2013 were eligible to the retrospective cohort. The considered follow-up period was within 30 days from the index procedure. The outcomes evaluated were the length of stay, blood transfusion, intensive care unit admission, in-hospital mortality, use of antibiotics, the development of anastomotic leakage, readmission, and the total hospital costs including re-admissions. Two hundred eighty patients, who met the eligibility criteria, were included in the analysis. Patients in the laparoscopic group had a shorter length of stay in comparison with the open group (6.02 ± 3.86 vs 9.86 ± 16.27, P < .001). There were no significant differences in other clinical outcomes between the 2 groups. The total costs were similar between the 2 groups, in the multivariate analysis (generalized linear model ratio of means 1.20, P = .074). The cost predictors were the cancer diagnosis and age. Laparoscopic colorectal surgery presents a 17% decrease in the duration of the hospital stay without increasing the total hospitalization costs. The factors associated with increased hospital costs were age and the diagnosis of cancer.

show abstract

Is the laparoscopic approach for rectal cancer superior to open surgery? A systematic review and meta-analysis on short-term surgical outcomes.

Cited by 21 publications

References 37 publications

Defunctioning ileostomy and mechanical bowel preparation may contribute to development of low anterior resection syndrome.

Defunctioning ileostomy and mechanical bowel preparation may contribute to development of low anterior resection syndrome.

Chrysophanol exhibits inhibitory activities against colorectal cancer by targeting decorin

Laparoscopic vs open colorectal surgery

Contact Info

Product

Resources

About