Laparoskopische Operationen bei Rektumkarzinomen. Kurzzeitvorteile und onkologische ergebnisse beim einsatz von mehr als einer methode

Translated title of the contribution: TechnikLaparoscopic surgery for rectal cancer. Short-term benefits and oncologic outcomes using more than one technique

David Larson, S. Y. Boostrom, R. R. Cima, J. H. Pemberton, D. R. Larson, Eric Dozois

Research output: Contribution to journalReview article

1 Citation (Scopus)

Abstract

Purpose. A number of minimally invasive techniques have now been described for rectal cancer resection. However, current outcome data for these approaches from high-volume single institutions remain limited. Our aim was to review outcomes in patients currently undergoing minimally invasive surgery for rectal cancer at our institution.Methods. A retrospective analysis was performed to assess short-term benefits and oncologic outcomes in patients undergoing minimally invasive surgery for rectal cancer between 2004 and 2007.Results. A total of 100 consecutive patients (61 men, median age 62) with a median follow-up of 1.8 years were identified. Of these, 67 underwent hand-assisted laparoscopic surgery (HALS) and 33 laparoscopic-assisted (LA) procedures. In all, 72 patients underwent anterior resection, 27 abdominal perineal resection, and one total proctocolectomy. Tumor stages were stage 1 (21%), stage 2 (17%), stage 3 (56%), and stage 4 (6%). A median of 16 lymph nodes were removed, while both a median distal margin of 3.4 cm and a 99% negative circumferential margin were achieved. The 3-year disease-free and overall survival rates were 86.2 and 94.5%, respectively. Three cases required conversion. Median time to both food intake and first bowel movement was 3 days, while the median length of stay was 5 days. Length of stay, time to soft diet, incision length, and pain scores were less using an LA approach compared to HALS (P<0.01). Overall morbidity was 26% with no mortality.Conclusions. Both minimally invasive techniques used achieved excellent oncologic results in patients with rectal cancer. The LA approach had slightly better short-term outcomes.

Original languageGerman
Pages (from-to)145-151
Number of pages7
JournalColoproctology
Volume33
Issue number3
DOIs
StatePublished - Jun 2011

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Rectal Neoplasms
Hand-Assisted Laparoscopy
Minimally Invasive Surgical Procedures
Length of Stay
Disease-Free Survival
Survival Rate
Eating
Lymph Nodes
Diet
Morbidity
Pain
Mortality
Neoplasms

Keywords

  • Hand-assisted laparoscopic surgery
  • Laparoscopy
  • MIS method
  • Rectal carcinoma
  • Rectal neoplasms

ASJC Scopus subject areas

  • Gastroenterology
  • Surgery

Cite this

Laparoskopische Operationen bei Rektumkarzinomen. Kurzzeitvorteile und onkologische ergebnisse beim einsatz von mehr als einer methode. / Larson, David; Boostrom, S. Y.; Cima, R. R.; Pemberton, J. H.; Larson, D. R.; Dozois, Eric.

In: Coloproctology, Vol. 33, No. 3, 06.2011, p. 145-151.

Research output: Contribution to journalReview article

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abstract = "Purpose. A number of minimally invasive techniques have now been described for rectal cancer resection. However, current outcome data for these approaches from high-volume single institutions remain limited. Our aim was to review outcomes in patients currently undergoing minimally invasive surgery for rectal cancer at our institution.Methods. A retrospective analysis was performed to assess short-term benefits and oncologic outcomes in patients undergoing minimally invasive surgery for rectal cancer between 2004 and 2007.Results. A total of 100 consecutive patients (61 men, median age 62) with a median follow-up of 1.8 years were identified. Of these, 67 underwent hand-assisted laparoscopic surgery (HALS) and 33 laparoscopic-assisted (LA) procedures. In all, 72 patients underwent anterior resection, 27 abdominal perineal resection, and one total proctocolectomy. Tumor stages were stage 1 (21{\%}), stage 2 (17{\%}), stage 3 (56{\%}), and stage 4 (6{\%}). A median of 16 lymph nodes were removed, while both a median distal margin of 3.4 cm and a 99{\%} negative circumferential margin were achieved. The 3-year disease-free and overall survival rates were 86.2 and 94.5{\%}, respectively. Three cases required conversion. Median time to both food intake and first bowel movement was 3 days, while the median length of stay was 5 days. Length of stay, time to soft diet, incision length, and pain scores were less using an LA approach compared to HALS (P<0.01). Overall morbidity was 26{\%} with no mortality.Conclusions. Both minimally invasive techniques used achieved excellent oncologic results in patients with rectal cancer. The LA approach had slightly better short-term outcomes.",
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AU - Larson, David

AU - Boostrom, S. Y.

AU - Cima, R. R.

AU - Pemberton, J. H.

AU - Larson, D. R.

AU - Dozois, Eric

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N2 - Purpose. A number of minimally invasive techniques have now been described for rectal cancer resection. However, current outcome data for these approaches from high-volume single institutions remain limited. Our aim was to review outcomes in patients currently undergoing minimally invasive surgery for rectal cancer at our institution.Methods. A retrospective analysis was performed to assess short-term benefits and oncologic outcomes in patients undergoing minimally invasive surgery for rectal cancer between 2004 and 2007.Results. A total of 100 consecutive patients (61 men, median age 62) with a median follow-up of 1.8 years were identified. Of these, 67 underwent hand-assisted laparoscopic surgery (HALS) and 33 laparoscopic-assisted (LA) procedures. In all, 72 patients underwent anterior resection, 27 abdominal perineal resection, and one total proctocolectomy. Tumor stages were stage 1 (21%), stage 2 (17%), stage 3 (56%), and stage 4 (6%). A median of 16 lymph nodes were removed, while both a median distal margin of 3.4 cm and a 99% negative circumferential margin were achieved. The 3-year disease-free and overall survival rates were 86.2 and 94.5%, respectively. Three cases required conversion. Median time to both food intake and first bowel movement was 3 days, while the median length of stay was 5 days. Length of stay, time to soft diet, incision length, and pain scores were less using an LA approach compared to HALS (P<0.01). Overall morbidity was 26% with no mortality.Conclusions. Both minimally invasive techniques used achieved excellent oncologic results in patients with rectal cancer. The LA approach had slightly better short-term outcomes.

AB - Purpose. A number of minimally invasive techniques have now been described for rectal cancer resection. However, current outcome data for these approaches from high-volume single institutions remain limited. Our aim was to review outcomes in patients currently undergoing minimally invasive surgery for rectal cancer at our institution.Methods. A retrospective analysis was performed to assess short-term benefits and oncologic outcomes in patients undergoing minimally invasive surgery for rectal cancer between 2004 and 2007.Results. A total of 100 consecutive patients (61 men, median age 62) with a median follow-up of 1.8 years were identified. Of these, 67 underwent hand-assisted laparoscopic surgery (HALS) and 33 laparoscopic-assisted (LA) procedures. In all, 72 patients underwent anterior resection, 27 abdominal perineal resection, and one total proctocolectomy. Tumor stages were stage 1 (21%), stage 2 (17%), stage 3 (56%), and stage 4 (6%). A median of 16 lymph nodes were removed, while both a median distal margin of 3.4 cm and a 99% negative circumferential margin were achieved. The 3-year disease-free and overall survival rates were 86.2 and 94.5%, respectively. Three cases required conversion. Median time to both food intake and first bowel movement was 3 days, while the median length of stay was 5 days. Length of stay, time to soft diet, incision length, and pain scores were less using an LA approach compared to HALS (P<0.01). Overall morbidity was 26% with no mortality.Conclusions. Both minimally invasive techniques used achieved excellent oncologic results in patients with rectal cancer. The LA approach had slightly better short-term outcomes.

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