복강경 직장암 절제술: 2년 이상 추적 관찰한 110명 환자의 종양학적 결과Laparoscopic Resection of Rectal Cancer: Oncologic Results of 110 Patients with Minimum 2-year Follow-up after a Curative Resection
- Other Titles
- Laparoscopic Resection of Rectal Cancer: Oncologic Results of 110 Patients with Minimum 2-year Follow-up after a Curative Resection
- Authors
- 조용걸; 김선한; 한구용; 유상화; 정춘식; 이동근
- Issue Date
- Apr-2006
- Publisher
- 대한대장항문학회
- Keywords
- Laparoscopic resection; Rectal cancer; Oncologic outcomes
- Citation
- Annals of Coloproctology, v.22, no.2, pp 118 - 124
- Pages
- 7
- Journal Title
- Annals of Coloproctology
- Volume
- 22
- Number
- 2
- Start Page
- 118
- End Page
- 124
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/18903
- ISSN
- 2287-9714
2287-9722
- Abstract
- PURPOSE
This study aimed to assess the oncologic outcomes after a laparoscopic resection in rectal cancer patients with minimum 2-year follow-up.
METHODS
Among the 312 patients undergoing a laparoscopic rectal cancer resection between Jan. 2000 and Dec. 2004 at Hansol Hospital, 110 patients who had been followed-up for longer than 24 months (mean 33, range 24~56) after the curative resection were included in this study. Two patients (1.8%) received preoperative chemoradiation. Five patients (4.5%) received radiotherapy postoperatively.
RESULTS
TNM stage was 0 in 5 patients, I in 25 (22.7%), II in 35 (31.8%), and III in 45 (40.9%). The T stage was as follows; Tis:T1:T2:T3:T4=4.5%:3.6%:25.5%:40.9%:25.5%. A protective ileostomy was performed in nine patients. The mean operative time was 208 minutes, and the mean blood loss was 179 ml. The mean number of removed lymph nodes was 18, and the mean distal margin was 3.0 cm. The radial margin was positive in one case. Conversion was required in three cases (2.7%). The overall morbidity rate was 17.2%. Anastomotic leak age occurred in five patients (5.5%). There was no operative mortality. During 33 months of mean follow-up, distant metastases and local recurrence were seen in 17 (15.5%) and 5 patients (4.5%), respectively. None had port-site recurrence. For the 94 patients with rectal cancer within 12 cm from the anal verge, the rate of local recurrence was 5.3%. The overall survival rate was 88.9% at 3 years (stage 0, I: 100.0%, stage II: 100.0%, stage III: 72.6%). The disease free survival rate was 78.8% at 3 years (stage 0, I: 100.0%, stage II: 88.6%, stage III: 56.9%).
CONCLUSIONS
A laparoscopic resection of rectal cancer provides an acceptable safety profile. If the highly selective indications for radiotherapy (6.3%) and the rather high volume of advanced cancers (stage III 40.9%, T3/4 66.4%) of this study are considered, a 4.5% local recurrence rate is promising. Optimal surgery for rectal cancer by using a laparoscopic technique may reduce the need for radiotherapy.
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Collections - 2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles
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