World Journal of Laparoscopic Surgery

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VOLUME 6 , ISSUE 3 ( September-December, 2013 ) > List of Articles

RESEARCH ARTICLE

Laparoscopic vs Open Total Mesorectal Excision for Rectal Cancer: A Clinical Comparative Study in a Government Sector Hospital

T Anil Kumar, Manash Ranjan Sahoo, Sunil Jaiswal

Citation Information : Kumar TA, Sahoo MR, Jaiswal S. Laparoscopic vs Open Total Mesorectal Excision for Rectal Cancer: A Clinical Comparative Study in a Government Sector Hospital. World J Lap Surg 2013; 6 (3):127-131.

DOI: 10.5005/jp-journals-10033-1197

Published Online: 01-08-2016

Copyright Statement:  Copyright © 2013; The Author(s).


Abstract

Aims and objectives

To assess feasibility, advantages, oncological safety, cost-effectiveness and short-term results of laparoscopic vs open total mesorectal excision (TME) for rectal cancer in a government sector hospital.

Patients and methods

This comparative nonrandomized retrospective study analyzes the data of 70 patients with rectal cancer treated with low anterior resection (LAR) or abdominoperineal resection (APR) from May 2007 to June 2012. Of these 40 patients underwent laparoscopic TME and 30 underwent open TME. Both the groups were comparable.

Results

Laparoscopic surgery took longer to perform (200 vs 150 min), but was accompanied by less blood loss (200 vs 800 ml) and fewer postoperative complications. Enteric function recovered sooner after laparoscopy than open surgery. Hospital stay was shorter for patients who underwent a laparoscopic surgery (7 vs 10 days). The mean number of harvested lymph nodes was greater in the laparoscopic group than in the open group (12 ± 3 vs 9 ± 2). Mean follow-up time was 30 months (range: 28-32 months). No local recurrence was found.

Conclusion

This study shows that laparoscopic TME for rectal cancer is a safe and feasible technique with some short-term benefits over open TME.

How to cite this article

Sahoo MR, Kumar TA, Jaiswal S. Laparoscopic vs Open Total Mesorectal Excision for Rectal Cancer: A Clinical Comparative Study in a Government Sector Hospital. World J Lap Surg 2013;6(3):127-131.


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  1. The mesorectum in cancer surgery: the clue to pelvic recurrence? Br J Surg 1982 Oct;69(10):613-616.
  2. Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus. Br J Surg 1995 Oct;82(10):1297-1299.
  3. The role of total mesorectal excision in the management of rectal cancer. Cancer Control 2003 May-Jun;10(3):205-211.
  4. Results of radical surgery for rectal cancer. World J Surg 1992 Sep-Oct;16(5):848-857.
  5. Current status of total mesorectal excision and autonomic nerve preservation in rectal cancer. Semin Surg Oncol 2000 Dec;19(4):321-328.
  6. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 2002;359:2224-2229.
  7. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004;350:2050-2059.
  8. Laparoscopic surgery versus open surgery for colon cancer: short term outcomes of a randomised trial. Lancet Oncol 2005 Jul;6(7):477-484.
  9. Shortterm quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA 2002 Jan;287(3):321-328.
  10. Goldstein AS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparos Endosc 1991 Sep;1(13):144-150.
  11. Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 2003 Aug;46(8):1047-1053.
  12. Subcutaneous metastases after laparoscopic colectomy. Lancet 1994 Jul;344(8914):58.
  13. Port site metastases and recurrence after laparoscopic colectomy: a randomized trial. Surg Endosc 1998 Aug;12(8):1039-1042.
  14. Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 1995 Mar;82(3):295-298.
  15. Minimally invasive surgery for rectal cancer. Surg Clin N Am 2005 Feb;85(1):61-73.
  16. Systemic and peritoneal inflammatory response after laparoscopic or conventional colon resection in cancer patients: a prospective, randomized trial. Dis Colon Rectum 2003 Feb;46(2):147-155.
  17. Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc 2003 Apr;17(4):636-640.
  18. Better preservation of immune function after laparoscopic-assisted vs open bowel resection in a murine model. Dis Colon Rectum 1996 Oct;39(10 Suppl):S67-S72.
  19. Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. Dis Colon Rectum 2002 Dec;45(12):1648-1654.
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