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Laparoscopic Versus Open Approach for Intersphincteric Resection-Results from a Tertiary Cancer Center in India.
Vishwas D Pai1, Pavan Sugoor1, Prachi S Patil2
1Department of Surgical Oncology, Tata Memorial Centre, Ernest Borges Road, Mumbai, Maharashtra 400012 India.
Indian Journal of Surgical Oncology
|December 6, 2017
Summary
Laparoscopic intersphincteric resection (LISR) shows promising short-term oncological outcomes compared to open intersphincteric resection (OISR) for rectal cancer. LISR demonstrated no circumferential resection margin involvement, suggesting improved safety in selected patients.
Area of Science:
- Colorectal Surgery
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Rectal cancer treatment often involves complex surgical resections.
- Intersphincteric resection (ISR) is a technique to preserve anal function.
- Comparing open (OISR) and laparoscopic (LISR) approaches is crucial for optimizing outcomes.
Purpose of the Study:
- To compare short-term oncological and clinical outcomes of OISR versus LISR for rectal cancer.
- To evaluate the safety and efficacy of laparoscopic intersphincteric resection.
- To assess oncological parameters like margin involvement and node harvest.
Main Methods:
- Retrospective review of a prospectively maintained database.
- Inclusion of rectal cancer patients who underwent ISR between July 2013 and November 2015.
- Comparison of oncological (CRM, distal margin, nodes) and perioperative outcomes (blood loss, hospital stay, morbidity, mortality) using Chi-square test.
Main Results:
- 39 OISR and 34 LISR cases were analyzed; groups were comparable except for higher BMI in LISR.
- No conversions were reported in the LISR group.
- Circumferential resection margin (CRM) involvement was observed in 10% of OISR cases versus 0% in LISR cases.
- Median hospital stay was similar between both groups.
Conclusions:
- Laparoscopic intersphincteric resection (LISR) is a safe and feasible alternative to open surgery for selected rectal cancer patients.
- LISR demonstrated a potential advantage in achieving negative circumferential resection margins.
- Further research may explore long-term outcomes and broader applicability of LISR.
