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Local recurrence and survival after laparoscopic mesorectal resection forrectal adenocarcinoma
E C Poulin1, C M Schlachta, R Grégoire
1Centre for Minimally Invasive Surgery, St. Michael's Hospital, University of Toronto, 30 Bond Street, Ontario, Canada M5B1W8. eric.poulin@utoronto.ca
Background:
Laparoscopic resection for rectal cancer is controversial. Actuarial survival and local recurrence rates have not been determined.
Methods:
A prospective database containing 80 consecutive unselected laparoscopic resections of rectal cancers performed between November 1991 and 1999 was reviewed. Local recurrence was defined as any detectable local disease at follow-up assessment occurring either alone or in conjunction with generalized recurrence. The tumor node metastases (TNM) classification for colorectal cancers and the Kaplan-Meier method were used to determine staging and survival curves. The mesorectal excision technique was used during surgery.
Results:
The median follow-up period was 31 months for patients with stages I, II, and III cancer, and 15.5 months for patients with stage IV cancer. The overall 5-year survival rate was 65.1% for all cancer stages and 72.1% for stages I, II, and III cancer. No trocar-site recurrence was observed. The overall local recurrence rate was 3.75% (3/80) for all cancer stages, and 4.3% (3/70) for stages I, II, and III cancer.
Conclusions:
The survival and local recurrence rates for patients with rectal cancer treated by laparoscopic mesorectal excision do not differ negatively from those in the literature for open mesorectal excision. Further validation is needed.