Laparoscopic total mesorectal excision following long course chemoradiotherapy for locally advanced rectal cancer

Abstract

Laparoscopic TME after LCRT is feasible and safe both oncologically and surgically. Serial MRI helps to determine the optimum timing of surgery.

Persistent Asymptomatic Anastomotic Leakage After Laparoscopic Sphincter-Saving Surgery for Rectal Cancer: Can Diverting Stoma Be Reversed Safely at 6 Months?

“…our 16% reported rate of symptomatic anastomotic leakage compares favorably with previous reports on similar populations. 21,22 finally, in an attempt to limit the rate of anastomotic leakage, we routinely performed a diverting loop ileostomy in all our patients undergoing sphincter-saving tme, which has been demonstrated to lower the risk of anastomotic leakage. 7,23 in all of the patients in this study, stoma reversal was postponed until spontaneous anastomotic leakage healing was observed on a new Ct scan that was repeated every 6 weeks.…”

Effect of Interval between Neoadjuvant Chemoradiotherapy and Surgery on Oncological Outcome for Rectal Cancer: A Systematic Review and Meta-Analysis

“…Another concern of delaying surgery is that longer intervals after preoperative radiation may increase the risk of emergence of distant subclinical tumor, which can grow to a metastasis-yielding volume and lead to the development of distant metastases [ 34 ]. Despite several studies reporting promising use of imaging technology to help in monitoring disease response during preoperative treatment, no robust imaging technology has been established for widespread clinical use [ 35 , 36 ]. Based on these concerns, further delaying time interval (>10 weeks) may be inappropriate.…”

Open or laparoscopic resection: does approach matter?

“…In a series of 274 patients reported by Runkel and Reiser [47] , only 1.8% of the patients required prolonged urinary catheterization postoperatively. In other studies, the rate of urinary dysfunction after laparoscopic TME ranged from 6% to 15% [48][49][50][51][52] , and the incidence of dysfunction ranged between 5% and 28% in males who were sexually active before laparoscopic TME [34,47,51,52] .…”