Laparoscopic surgery for rectal cancer: Short-term benefits and oncologic outcomes using more than one technique

D. W. Larson, S. Y. Boostrom, R. R. Cima, J. H. Pemberton, D. R. Larson, E. J. Dozois

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background Several minimally invasive techniques have now been described for rectal cancer resection. Current outcome data for these approaches from high volume, single institutions remain limited. Our aim was to review outcomes in patients undergoing minimally invasive surgery for rectal cancer at our institution in the current era. Methods A retrospective analysis was done to assess short-term benefits and oncologic outcomes in patients undergoing minimally invasive surgery for rectal cancer between 2004 and 2007. Results One-hundred consecutive patients (61 men, median age 62) with a median follow-up of 1.8 years were identified. Sixty-seven had hand-assisted laparoscopic surgery (HALS), while 33 were done laparoscopic-assisted (LA). Seventy-two patients underwent anterior resection, 27 an abdominal perineal resection, and 1 a total proctocolectomy. Tumor stage was stage 1 (21%), stage 2 (17%), stage 3 (56%), and stage 4 (6%). A median of 16 lymph nodes, a median 3.4 cm distal margin, and a 99% negative circumferential margin was achieved. The 3-year diseasefree and overall survivals were 86.2 and 94.5%, respectively. Three cases required conversion. Median time to both diet and first bowel movement was 3 days, and median length of stay was 5 days. Length of stay, time to soft diet, incision length, and pain scores were less using a LA approach compared to HALS (P<0.01). Overall morbidity was 26% with no mortality. Conclusion Both minimally invasive techniques used achieved excellent oncologic results in patients with rectal cancer. The LA approach had slightly better short-term outcomes.

Original languageEnglish (US)
Pages (from-to)125-131
Number of pages7
JournalTechniques in Coloproctology
Volume14
Issue number2
DOIs
StatePublished - Jun 1 2010

Keywords

  • Hand-assisted laparoscopic surgery
  • Laparoscopy
  • Rectal neoplasms

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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