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Laparoscopic TME for rectal cancer: a case series
Andrew Day1, Ralph Smith, Iain Jourdan
1Minimal Access Therapy Training Unit, Postgraduate Medical School, University of Surrey, Guildford, UK. dayandrew@hotmail.co.uk
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|April 11, 2012
Summary
Laparoscopic total mesorectal excision (TME) for rectal cancer shows promising short-term outcomes and oncological equivalency to open surgery. However, conversion from laparoscopic to open procedures may negatively impact overall survival.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Laparoscopic colonic resection for cancer is established.
- Evidence for laparoscopic total mesorectal excision (TME) is limited but suggests improved outcomes.
Purpose of the Study:
- To evaluate the outcomes of laparoscopic TME for rectal cancer.
- To compare laparoscopic TME with open resection.
Main Methods:
- Retrospective analysis of 79 patients undergoing laparoscopic TME for rectal cancer (Oct 2003 - Dec 2010).
- Data collected from a prospective database.
- Survival analysis using the Kaplan-Meier method.
Main Results:
- Median length of stay was 5 days; no postoperative mortality.
- 5-year overall survival: 70%; 5-year disease-free survival: 65.5%.
- Conversion rate was 10.1%; conversion was associated with lower overall survival (70.6% vs 62.5%, P=0.041).
Conclusions:
- Laparoscopic TME appears equivalent to open TME for rectal cancer.
- Conversion from laparoscopic to open surgery may adversely affect overall survival.
