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

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

Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, cilt.29, sa.5, ss.354-361, 2019 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 5
  • Basım Tarihi: 2019
  • Doi Numarası: 10.1097/sle.0000000000000664
  • Dergi Adı: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.354-361
  • Anahtar Kelimeler: laparoscopic sphincter-preserving surgery, rectal cancer, total mesorectal excision
  • İstanbul Gelişim Üniversitesi Adresli: Evet

Özet

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.