Standardized Laparoscopic Sphincter-preserving Total Mesorectal Excision for Rectal Cancer: Median of 10 Years' Long-term Oncologic Outcome in 217 Unselected Consecutive Patients

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BADEMLER S., Koza K. B., Ucuncu M. Z., Tokmak H., BAKIR B., ORAL E. N., ...More

Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, vol.29, no.5, pp.354-361, 2019 (SCI-Expanded)

• Publication Type: Article / Article
• Volume: 29 Issue: 5
• Publication Date: 2019
• Doi Number: 10.1097/sle.0000000000000664
• Journal Name: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
• Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
• Page Numbers: pp.354-361
• Keywords: laparoscopic sphincter-preserving surgery, rectal cancer, total mesorectal excision
• Istanbul Gelisim University Affiliated: Yes

Abstract

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.This study was designed to evaluate the impact of a standardized laparoscopic total mesorectal excision (TME) on the long-term oncologic outcome. Unselected consecutive patients with rectal cancer underwent a standardized laparoscopic TME with medial to lateral approach encompassing 9 sequential steps. From 2005 to June 2012, laparoscopic sphincter-preserving TME was attempted in 217 patients. Mean follow-up of all patients was a median of 91 months (range, 3 to 164 mo). The local recurrence rate was 6.5%, and the distant recurrence rate was 19.8%. The 10-year disease-free survival (DFS) rates were 76.4% and overall survival (OS) was 67.1%. In the converted group, DFS and OS were 50% and 46.7%, respectively. In the laparoscopic group, DFS and OS were 78.3% and 68.5%, respectively. A standardized laparoscopic sphincter-preserving TME resulted in a favorable long-term oncologic outcome in unselected patients with rectal cancer. Conversion to open surgery has impaired OS and DFS.