Short-term results in mid and low rectal cancer with laparoscopic and open surgery

Objective This study was performed to evaluate the 1-year survival rate and functional outcomes of 20 patients who underwent intersphincteric resection (ISR) for low rectal cancer. Methods Twenty patients who underwent ISR for low rectal cancer were followed up for 1 year. Complications, functional outcomes objectified by the Wexner score, and oncological outcomes were assessed. Results The short-term survival rate was 100%. The median Wexner score was ≤10 in all patients at 12 months after surgery. Signs of local recurrence were absent, and antigen levels remained within the reference ranges 1 year postoperatively. Conclusions ISR is a feasible alternative in highly selected patients who primarily refuse a colostomy bag and present with type II or III tumors. In the present study, patient-reported continence was satisfactory, and the absence of a colostomy bag increased patients’ quality of life. The oncological outcomes were satisfactory at 1 year postoperatively.

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Influence of Minimally Invasive Resection Technique on Sphincter Preservation and Short-term Outcome in Low Rectal Cancer in the Netherlands

Diseases of the Colon & Rectum ◽

10.1097/dcr.0000000000001906 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Marieke L. Rutgers ◽

Robin Detering ◽

Sapho X. Roodbeen ◽

Rogier M. Crolla ◽

Jan Willem T. Dekker ◽

...

Keyword(s):

Rectal Cancer ◽

The Netherlands ◽

Minimally Invasive ◽

Sphincter Preservation ◽

Low Rectal Cancer ◽

Short Term ◽

Term Outcome ◽

Short Term Outcome

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Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial

The Lancet Oncology ◽

10.1016/s1470-2045(13)70016-0 ◽

2013 ◽

Vol 14 (3) ◽

pp. 210-218 ◽

Cited By ~ 803

Author(s):

Martijn HGM van der Pas ◽

Eva Haglind ◽

Miguel A Cuesta ◽

Alois Fürst ◽

Antonio M Lacy ◽

...

Keyword(s):

Rectal Cancer ◽

Open Surgery ◽

Short Term ◽

Phase 3

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Robot-assisted vs laparoscopic vs open abdominoperineal resections for low rectal cancer: Short-term outcomes of a single-center prospective randomized controlled trial

Annals of Oncology ◽

10.1093/annonc/mdx393.009 ◽

2017 ◽

Vol 28 ◽

pp. v161-v162 ◽

Cited By ~ 2

Author(s):

J. Xu ◽

Y. Wei ◽

L. Ren ◽

Q. Feng ◽

J. Chen ◽

...

Keyword(s):

Rectal Cancer ◽

Randomized Controlled Trial ◽

Controlled Trial ◽

Low Rectal Cancer ◽

Single Center ◽

Robot Assisted ◽

Short Term ◽

Randomized Controlled ◽

Prospective Randomized Controlled Trial

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Sphincter Preservation After Short-term Preoperative Radiotherapy for Low Rectal Cancer - Presentation of Own Data and a Literature Review

Acta Oncologica ◽

10.1080/028418601750444132 ◽

2001 ◽

Vol 40 (5) ◽

pp. 593-601 ◽

Cited By ~ 27

Author(s):

Krzysztof Bujko, Marek P. Nowacki,

Keyword(s):

Rectal Cancer ◽

Literature Review ◽

Preoperative Radiotherapy ◽

Sphincter Preservation ◽

Low Rectal Cancer ◽

Short Term

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Comparison of long-term survival outcomes between laparoscopic and open surgery for mid or low rectal cancer treated with preoperative chemoradiotherapy: 7-year follow-up of COREAN trial.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.3518 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 3518-3518

Author(s):

Ji Won Park ◽

Seung-Yong Jeong ◽

Sung-Bum Kang ◽

Jungnam Joo ◽

Mi Kyung Song ◽

...

Keyword(s):

Rectal Cancer ◽

Laparoscopic Surgery ◽

Local Recurrence ◽

Open Surgery ◽

Disease Free Survival ◽

Preoperative Chemoradiotherapy ◽

Low Rectal Cancer ◽

Free Survival ◽

Disease Free

3518 Background: Laparoscopic surgery for rectal cancer has been used widely. However, recent two randomized trials raised concerns about short-term oncologic safety of laparoscopic surgery for rectal cancer. The aim of this study was to evaluate the long-term oncologic safety of laparoscopic surgery for rectal cancer based on 7-year data from the Comparison of Open versus laparoscopic surgery for mid or low REctal cancer After Neoadjuvant chemoradiotherapy (COREAN) trial. Methods: COREAN trial was a non-inferiority, randomized controlled trial. Between April, 2006, and Aug, 2009, eligible participants with mid or low rectal cancer treated with preoperative chemoradiotherapy were randomly assigned (1:1) to laparoscopic (n = 170) or open surgery (n = 170). Seven-year outcomes included overall and disease-free survival, and local recurrence. Log-rank test and stratified Cox regression analysis were used for survival analysis. Analysis was by intention to treat. Results: The median follow-up times were 84 months (IQR: 61.5-97.0). No differences were found between laparoscopic and open surgery group in terms of overall and disease-free survival, and local recurrence (7-year overall survival: 83.2% [laparoscopic] vs 77.3% [open], p = 0.48; 7-year disease-free survival: 71.6% [laparoscopic] vs 64.3% [open], p = 0.20; 7-year local recurrence: 3.3% [laparoscopic] vs 7.9% [open], p = 0.08). Stratified Cox regression analysis adjusted for ypT, ypN and tumor regression grade showed no significant difference between groups in terms of overall and disease-free survival, and local recurrence. The hazard ratios for overall survival, disease-free survival and local recurrence (open vs laparoscopic surgery) were 0.96 (95% CI = 0.58-1.57), 1.03 (95% CI = 0.70-1.53), and 2.28 (95% CI = 0.82-7.16), respectively. Conclusions: The 7-year analysis confirm the long-term oncological safety of laparoscopic surgery for rectal cancer treated with preoperative chemoradiotherapy. The use of laparoscopic surgery does not compromise the long-term survival outcomes in rectal cancer. Clinical trial information: NCT00470951.

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Robotic vs. laparoscopic vs. open abdominoperineal resection for low rectal cancer: Short-term outcomes of a single-center prospective randomized controlled trial.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.3603 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 3603-3603 ◽

Cited By ~ 2

Author(s):

Ye Wei ◽

Jianmin Xu ◽

Li Ren ◽

Qingyang Feng ◽

Guodong He ◽

...

Keyword(s):

Clinical Trial ◽

Rectal Cancer ◽

Randomized Controlled Trial ◽

Complication Rate ◽

Open Surgery ◽

Resection Margin ◽

Controlled Trial ◽

Low Rectal Cancer ◽

Postoperative Complication Rate ◽

Randomized Controlled

3603 Background: Currently, robotic surgery for rectal cancer using da Vinci System is common. However, there is almost no clinical trial reported. This randomized controlled trial aims to compare the safety and efficacy of robotic, laparoscopic and open abdominoperineal resection (APR) for low rectal cancer. Methods: From September 2013 to August 2016, patients aged from 18 to 75 years, with low rectal cancer within 5 cm from anal verge, clinical T1 to T3, no distant metastases, were randomly assigned to receive either robotic procedures (RAP), laparoscopic procedures (LAP) or open surgery (OS) for APR in 1:1:1 ratio. The primary endpoint was postoperative complication rate. This study is registered with ClinicalTrials.gov (NCT01985698). Results: Totally 406 patients were randomly assigned. Actually, 135 finished RAP, 131 finished LAP, and 137 finished OS (including 4 convert from LAP to OS). RAP had significantly lower postoperative complication rate (11.1%) than both LAP (21.4%, P = 0.023) and OS (27.7%, P = 0.001). Also, RAP reduced intraoperative hemorrhage (median [interquartile range], 100 [90-110] ml) than LAP (130 [100-150] ml, P < 0.001) and OS (150 [120-260] ml, P < 0.001). And RAP promoted postoperative recovery, with shorter days to first flatus (1.0 [1.0-2.0] day) than LAP (2.0 [2.0-3.0] day, P < 0.001) and OS (3.0 [2.0-4.0] day, P < 0.001), shorter days to first automatic urination (2.0 [2.0-3.0] day) than LAP (3.0 [2.0-4.0] day, P < 0.001) and OS (3.0 [2.0-4.0] day, P < 0.001), and shorter days to discharge (5.0 [5.0-6.0] days) than LAP (6.0 [5.0-7.0] days, P < 0.001) and OS (6.0 [5.0-7.0] day, P = 0.005). There was no significant difference in open conversion rate, resection margin involvement (including circumferential resection margin), number of lymph node harvested and pathological tumor stage. Conclusions: Robotic APR was safer, and reproduce equivalent surgical quality of conventional laparoscopic and open surgery. Also, it provided less injury and faster functional recovery. Clinical trial information: NCT01985698.

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