scholarly journals Long-term oncologic outcomes of laparoscopic low anterior resection of rectal cancer with preservation of the left colic artery

2020 ◽  
Author(s):  
Yuwen Luo ◽  
Rongjiang Li ◽  
Deqing Wu ◽  
Jun Zeng ◽  
Junjiang Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Oncologic Outcomes ◽  
Colic Artery ◽  
Left Colic Artery ◽  
Laparoscopic Low Anterior Resection ◽  
The Difference

Abstract Aim To analyze the effect of preserving the left colic artery (LCA) on long-term oncologic outcomes during laparoscopic low anterior resection of rectal cancer. Methods Clinicopathological and follow-up patients undergoing laparoscopic low anterior resection of rectal cancer in general surgery department of Guangdong Provincial People's Hospital from January 2014 to December 2015 were retrospectively collected. According to the difference surgical methods of inferior mesenteric artery (IMA), 159 cases were divided into the LCA preservation group and 225 cases in the LCA non-preservation group. The 5-year rates of overall survival (OS) and disease-free survival (DFS) were compared between two group. Results 384 patients were included in final analysis. Anastomotic leakage occurred in 7 patients (4.4%) in the LCA preservation group and in 16 patients (7.1%) in the LCA non-preservation group. The follow-up rate was 91.2% (145/159) during 5–60 months in LCA preservation group, and 89.8% (202/225) during 5–60 months in the LCA non-preservation group. The number of patients who developed death, local recurrence and metastasis were 59 (37.1%), 13 (8.2%) and 60 (37.7%) in the LCA preservation group, and 86 (38.2%), 20 (8.9%) and 92 (40.9%) in the LCA non-preservation group, without significant differences (all P ༞ 0.05). The 5-year OS and DFS rates were 69.0% and 59.3% in the LCA preservation group, and 68.8% and 55.9% in the LCA non-preservation group, without significant differences (all P ༞ 0.05). After stratification by TNM Stage, the difference on 5-year OS rates and DFS rates of I stage, II stage and III stage in two groups were no significant as well (all P ༞ 0.05). Conclusions The long-term oncologic outcomes of laparoscopic low anterior resection of rectal cancer with preservation of the LCA are comparable with ligation at origin of IMA.

scholarly journals Long-term oncological outcomes of low anterior resection for rectal cancer with and without preservation of the left colic artery: A retrospective cohort study.

2020 ◽  
Author(s):  
Yuwen Luo ◽  
Rongjiang Li ◽  
Deqing Wu ◽  
Jun Zeng ◽  
Junjiang Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Disease Free Survival ◽  
Colic Artery ◽  
Left Colic Artery ◽  
Oncological Outcomes ◽  
Tumor Node Metastasis Stage

Abstract BackgroundThere is uncertainty in the literature about the best surgical approach for low anterior resection of rectal cancer to deal with the inferior mesenteric artery (IMA), that is to preserve left colic artery or not. We analyzed the effect of preserving the left colic artery (LCA) on long-term oncological outcomes. MethodsWe retrospectively collected clinicopathological and follow-up details of patients who underwent low anterior resection for rectal cancer in the General Surgery Department of Guangdong Provincial People's Hospital, from January 2014 to December 2015. Cases were divided into low ligation (LL) or high ligation (HL) of the IMA The 5-year overall survival (OS) and disease-free survival (DFS) rates were compared between the two groups. ResultsAltogether, there were 221 cases in the LL group (LCA preserved) and 295 cases in the HL group (LCA not preserved). Postoperative 30-day mortality was 0.9% in the LL group and 1.4% in the HL group. Early complications occurred in 41.2% patients in the LL group and 38.3% in the HL group. Anastomotic leakage occurred in 8.6% of patients in the LL group and in 13.2% in the HL group. The numbers of lymph nodes harvested were 18.8 ± 9.6 in the LL group and 17.0 ± 6.6 in the HL group. The median follow-up periods were 51.4 (7–61) months in the LL group and 51.2 (8–61) months in the HL group. During follow-up, the percentages of patients who died, had local recurrence, or had metastases were 39.8%, 7.7%, and 38.5%, respectively, in the LL group and 39%, 8.5%, and 40%, respectively, in the HL group; these differences were not significant (all P ＞ 0.05). The 5-year OS and DFS were 69.6% and 59.6% in the LL group, respectively, and 60.1% and 56.2% in the HL group, respectively; these differences were not significant (all P ＞ 0.05). After stratification by tumor-node-metastasis stage, the difference between the 5-year OS and DFS for stages I, II, and III cancer were not significant (all P ＞ 0.05). ConclusionsThe long-term oncological outcomes of low anterior resection for rectal cancer with preservation of the LCA are comparable with those of ligation at the IMA origin.

scholarly journals Long-term oncological outcomes of low anterior resection for rectal cancer with and without preservation of the left colic artery: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuwen Luo ◽  
Rongjiang Li ◽  
Deqing Wu ◽  
Jun Zeng ◽  
Junjiang Wang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anastomotic Leakage ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Colic Artery ◽  
Early Complications ◽  
Left Colic Artery ◽  
Oncological Outcomes

Abstract Background There is uncertainty in the literature about preserving the left colic artery (LCA) during low anterior resection for rectal cancer. We analyzed the effect of preserving the LCA on long-term oncological outcomes. Methods We retrospectively collected clinicopathological and follow-up details of patients who underwent low anterior resection for rectal cancer in the General Surgery Department of Guangdong Provincial People’s Hospital, from January 2014 to December 2015. Cases were divided into low ligation (LL), LCA preserved, or high ligation (HL), LCA not preserved, of the inferior mesenteric artery. The 5-year overall survival (OS) and disease-free survival (DFS) rates were compared between the two groups. Results Altogether, there were 221 and 295 cases in the LL group and HL groups, respectively. Operating time in the LL group was significantly longer than in the HL group (224.7 vs. 211.7 min, p = 0.039). Postoperative 30-day mortality, early complications including anastomotic leakage showed no significant differences between the LL and HL groups (postoperative 30-day mortality, 0.9% LL, 1.4% HL, p = 0.884; early complications, 41.2% LL, 38.3% HL, p = 0.509; anastomotic leakage 8.6% LL, 13.2% HL, p = 0.100). The median follow-up periods were 51.4 (7–61) months in the LL group and 51.2 (8–61) months in the HL group. During follow-up, the percentages of patients who died, had local recurrence, or had metastases were 39.8, 7.7, and 38.5%, respectively, in the LL group and 39, 8.5, and 40%, respectively, in the HL group; these differences were not significant (all p > 0.05). The 5-year OS and DFS were 69.6 and 59.6% in the LL group, respectively, and 69.1 and 56.2% in the HL group, respectively; these differences were not significant (all p > 0.05). After stratification by tumor-node-metastasis stage, the difference between the 5-year OS and DFS for stages I, II, and III cancer were not significant (all p > 0.05). Conclusions The long-term oncological outcomes of LL group are comparable with HL group. LL cannot be supported due to the absence of lower complication rates and the longer operating times.

Đánh giá chất lượng cuộc sống của bệnh nhân ung thư trực tràng trên và giữa được điều trị phẫu thuật nội soi cắt trực tràng trước thấp

2020 ◽  
Author(s):  
Thong Tran Ngoc
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Overall Survival Rate ◽  
Central Hospital ◽  
Laparoscopic Low Anterior Resection ◽  
The Mean

Introduction: Evaluation of the quality of life of patients with upper and middle rectal cancer treated with laparoscopic low anterior resection. Material and method: Prospective and previous research from 1/2013 to 9/2019 at Hue central hospital, a laparoscopic low anterior resection was performed in 86 patients with upper and mid rectal cancer. Result: There were 40 males and 45 females with the mean age of 62,95 ± 13,13; no conversion, have seven cases anastomotic leakage. Mean follow-up duration 60 months: have five cases local recurrence (5,9%), the overall survival rate after 5 years was 45%. Quality of Life of Patients is quiet good. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, quality of life of patient is quite good.

Oncologic Outcomes of ypT1-3N0 mid-Low Rectal Cancer Compared with pT1-3N0 Disease After Radical Resection

2020 ◽  
Author(s):  
Hong Yang ◽  
Jiabo Di ◽  
Ming Cui ◽  
Jiadi Xing ◽  
Chenghai Zhang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Chemoradiotherapy ◽  
Disease Free Survival ◽  
Radical Resection ◽  
Low Rectal Cancer ◽  
Oncologic Outcomes ◽  
Cancer Specific Survival ◽  
The Difference

Abstract Background: Neoadjuvant chemoradiotherapy (CRT) can downstage rectal carcinoma, resulting in superior resectability, better local control and survival benefits. However, it is unclear whether patients treated with CRT and those who did not have similar outcomes at the same pathological stage. This study aimed to investigate the long-term outcomes of ypT1-3N0 mid-low rectal cancer who received neoadjuvant CRT followed by total mesorectal excision (TME) compared with pT1-3N0 rectal cancer immediately managed with surgery. Methods: We retrospectively enrolled 180 patients with pT1-3N0 or ypT1-3N0 rectal cancer located within 10cm from the anal edge who underwent TME between 2009 and 2015. Of these patients, 63 received neoadjuvant CRT, while 117 underwent radical proctectomy without preoperative therapy. The disease-free survival (DFS) and cancer-specific survival (CSS) were compared between the two groups. Results: Within a median follow-up time of 65 months, the 5-year DFS was lower in the CRT group than the non-CRT group (74.9% vs. 92.6%, P=0.001), and the 5-year CSS presented a similar trend as well (89.6 % vs. 97.1%, P=0.054). By subgroup analysis, the difference in DFS and CSS was mainly caused by the difference between ypT3N0 and pT3N0 disease (71.1% vs. 96.1%, P＜0.001 and 90.9% vs. 100%, P=0.029, respectively). However, patients with ypT1-2N0 had an analogous prognosis to those with pT1-2N0 disease (77.9% vs. 89.0%, P=0.225 and 88.1% vs. 94.2%, P=0.292, respectively). Multivariate analysis indicated that neoadjuvant CRT was not an independent predictor of DFS. Conclusion: After neoadjuvant CRT followed by TME, patients with ypT1-2N0 rectal cancer had an analogous prognosis to those with initial pT1-2N0 disease, whereas patients with ypT3N0 rectal cancer had worse prognosis compared with that of pT3N0 disease.

scholarly journals Defunctioning stoma and short- and long-term outcomes after low anterior resection for rectal cancer—a nationwide register–based cohort study

2021 ◽  
Author(s):  
Soran Gadan ◽  
Judith S. Brand ◽  
Martin Rutegård ◽  
Peter Matthiessen
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Long Term Outcomes ◽  
Defunctioning Stoma ◽  
Oncological Outcomes ◽  
All Cause Mortality ◽  
Short And Long Term

Abstract Purpose A defunctioning stoma reduces the risk of symptomatic anastomotic leakage after low anterior resection for rectal cancer and mitigates the consequences when a leakage occurs, but the impact on mortality and oncological outcomes is unclear. The aim was to investigate the associations of a defunctioning stoma with short- and long-term outcomes in patients undergoing low anterior resection for rectal cancer. Methods Data from all patients who underwent curative low anterior resection for rectal cancer between 1995 and 2010 were obtained from the Swedish Colorectal Cancer Register. A total of 4130 patients, including 2563 with and 1567 without a defunctioning stoma, were studied. Flexible parametric models were used to estimate hazard ratios for all-cause mortality, 5-year local recurrence, and distant metastatic disease in relation to the use of defunctioning stoma, adjusting for confounding factors and accounting for potential time-dependent effects. Results During a median follow-up of 8.3 years, a total of 2169 patients died. In multivariable analysis, a relative reduction in mortality was observed up to 6 months after surgery (hazard ratio = 0.82: 95% CI 0.67–0.99), but not thereafter. After 5 years of follow-up, 4.2% (173/4130) of the patients had a local recurrence registered and 17.9% (741/4130) had developed distant metastatic disease, without difference between patients with and without defunctioning stoma. Conclusion A defunctioning stoma is associated with a short-term reduction in all-cause mortality in patients undergoing low anterior resection for rectal cancer without any difference in long-term mortality and oncological outcomes, and should be considered as standard of care.

EVALUATION THE RESULTS OF LAPAROSCOPIC LOW ANTERIOR RESECTION FOR TREATMENT UPPER AND MIDDLE RECTAL CANCER

2017 ◽  
pp. 182-189
Author(s):  
Ngoc Thang Tran ◽  
Ngoc Hung Dang ◽  
Manh Ha Le ◽  
Anh Vu Pham ◽  
Nhu Hiep Pham ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Overall Survival Rate ◽  
Central Hospital ◽  
Laparoscopic Low Anterior Resection ◽  
Rectal Cancer Treatment ◽  
The Mean ◽  
Initial Results

Introduction: To evaluate the feasibility and benefits of laparoscopic low anterior resection for upper and middle rectal cancer treatment. Material and method: Prospective study from 8/2013 to 8/2017 at Hue Central Hospital, a laparoscopic low anterior resection was performed in 45 patients with upper and mid rectal cancer. Result: There were 29 males and 16 females with the mean age of 60.3 ± 11.5 (range 38 – 75), no conversion, have three cases anastomotic leakage, the mortaliy rate was 0%. Mean follow-up duration 36 months: have tow cases local recurrence (4.4%), the overall survival rate was 100%. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, initial results is good. Key words: upper and middle rectal cancer, Laparoscopic low anterior resection

Comparison of Long-Term Functional Results of Colonic J-Pouch and Straight Anastomosis After Low Anterior Resection for Rectal Cancer: A Five-Year Follow-Up

2004 ◽  
Vol 47 (10) ◽  
pp. 1578-1585 ◽  
Author(s):  
Jin-ichi Hida ◽  
Takehito Yoshifuji ◽  
Tadao Tokoro ◽  
Kiyohiko Inoue ◽  
Tomohiko Matsuzaki ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Functional Results ◽  
J Pouch
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