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Laparoscopic resection for rectal cancer: A prospective analysis of thirty-month follow-up outcomes in 312 patients

Authors
Kim S.-H.Park I.-J.Joh Y.-G.Hahn K.-Y.
Issue Date
2006
Keywords
Laparoscopic resection; Mid-term outcome; Prospective; Rectal cancer
Citation
Surgical Endoscopy and Other Interventional Techniques, v.20, no.8, pp.1197 - 1202
Indexed
SCOPUS
Journal Title
Surgical Endoscopy and Other Interventional Techniques
Volume
20
Number
8
Start Page
1197
End Page
1202
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/19317
DOI
10.1007/s00464-005-0599-2
ISSN
0930-2794
Abstract
Background: This study aimed to prospectively evaluate operative safety and mid-term oncologic outcomes of laparoscopic rectal cancer resection performed by a single surgeon. Methods: Three hundreds twelve patients (male, 181) were enrolled in this analysis. 257 patients (82.4%) had tumors located below 12 cm from the anal verge. Distribution of TNM stages was 0:I:II:III:IV = 4.2%:17.9%:32.4%:37.2%:8.3%. 225 patients (71.1%) had T3/T4 lesions. Pre- and post-operative radiation was given in 6 and 20 patients, respectively. Results: Sphincter-preserving operation was performed in 85.9%. Mean operating time was 212 minutes. Conversion rate was 2.6%. Overall morbidity rate was 21.1%. Anastomotic leakage occurred in 6.4%. Operative mortality rate was 0.3%. Mean number of harvested nodes was 23. Mean distal tumor-free margin was 2.8 cm. The circumferential resection margin was positive in 13 patients (4.2%). With a mean follow-up of 30 months in the stage I-III patients, the local recurrence rate was 2.9%. Systemic recurrence occurred in 11.7%. No port-site recurrence was observed. Conclusion: Laparoscopic resection of rectal cancer provided safe operative parameters and adequate mid-term oncologic outcomes. When considering a high volume of advanced and low-lying cancers but rather narrow indication to radiotherapy, the 2.9% local recurrence rate seems promising data. Long-term follow-up is mandatory to draw conclusion. © Springer Science+Business Media, Inc. 2006.
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