Laparoscopic Resection of Rectal Cancer: A Comparison of Surgical and Oncologic Outcomes Between Extraperitoneal and Intraperitoneal Disease Locations

Abstract

Laparoscopic resection of rectal cancer, regardless of EP or IP, provided acceptable operative outcomes. There was an increasing tendency for positive circumferential margin, leakage, and local recurrence in EP vs. IP. A multicenter, prospective study is ongoing to identify the high-risk group for local recurrence who may really benefit from neoadjuvant therapy in the era of laparoscopy.

Laparoscopic rectal surgery for middle and lower rectal cancer

“…The local recurrence rate is representative of the longterm outcome along with survival. Three cases of local recurrence occurred during the follow-up period of this series and the local recurrence rate was 3.4%, which is comparable to that of other relatively large or prospective series of laparoscopic or open procedures [7,8,19,20,23]. There was no port-site recurrence or peritoneal seeding in this series, which indicates that avoiding tumor handling contributed to a better outcome.…”

“…This is similar to the rate reported previously. Also, the anastomotic leakage rate of 13.1% was within the range of other reports (9.8-21%) [7,8,19,20]. The rate is influenced by the definition of leakage.…”

“…In this series, the conversion rate was about 5%, which is good compared with the rates in recent reports [7,8,19]. Most of the conversions were related to problems with transection of the distal rectum in the very early period.…”

Single-Stage Totally Robotic Dissection for Rectal Cancer Surgery: Technique and Short-Term Outcome in 50 Consecutive Patients

“…There were some complications in the present study. Most of all, an 8.3% anastomotic leakage rate was comparable with the 9.7% rate of the laparoscopic TME in our previous study, 12 and was consistent with 12.1% of the largest series of robotic TMEs in Hellan's study. 9 Although morbidity was low, a mean length of hospital stay was nine days.…”

“…This institutional policy of neoadjuvant therapy was established based on our previous data. 12 All data were recorded prospectively on our database. This study was approved by the institutional review board of our institution and an informed consent was taken from all of the patients.…”