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Article: Laparoscopic and open anterior resection for upper and mid rectal cancer: An evaluation of outcomes

TitleLaparoscopic and open anterior resection for upper and mid rectal cancer: An evaluation of outcomes
Authors
KeywordsLaparoscopic anterior resection
Rectal cancer
Issue Date2006
PublisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/
Citation
Diseases Of The Colon And Rectum, 2006, v. 49 n. 8, p. 1108-1115 How to Cite?
AbstractPURPOSE: This study was designed to compare the outcomes of laparoscopic anterior resection with open operation for mid and upper rectal cancer. METHODS: A total of 265 patients who underwent elective laparoscopic or open anterior resection for cancer of the mid and upper rectum from June 2000 to December 2004 were included. Data about the patients' demographics, operative details, postoperative outcome, and disease status were collected prospectively. Comparison of the outcome between laparoscopic and open resection was performed. RESULTS: The median age of the 265 patients was 69 (range, 27-91) years, and laparoscopic anterior resection was performed in 98 patients (37 percent). There was no difference in the age, gender, comorbidities, and level of tumor between the two groups. The operating time was longer in the laparoscopic group (200 vs. 127 minutes; P < 0.01), but the blood loss was less (200 vs. 250 ml; P = 0.027). The overall operative mortality was 1.8 percent, and the complication rate was 27.9 percent. Significantly more patients with early diseases (Stage I and Stage II) were operated with laparoscopic approach. There was no difference in the mortality or morbidity between the two groups. Anastomotic leakage occurred in five patients with open resection and one with laparoscopic resection (P = 0.418). Patients with laparoscopic resection had an earlier return of bowel function and earlier resumption of diet as well as a shorter median hospital stay (7 vs. 8 days; P < 0.001). With the median follow-up of the surviving patients for 21.2 months, the three-year local recurrence rates for those with open and laparoscopic resection were 4.9 and 3.3 percent, respectively (P = 0.513). In patients with Stage I and Stage II disease, the three-year cancer-specific survivals for open and laparoscopic resection were 89.8 and 88.6 percent, respectively (P = 0.882), whereas those of patients with Stage III disease were 65.6 and 55.5 percent, respectively (P = 0.911). CONCLUSIONS: Laparoscopic anterior resection for mid and proximal rectal cancer is a safe option with short-term advantages compared with open operation. The oncologic outcomes of patients who underwent laparoscopic anterior resection were not compromised, with similar local recurrence rate and the cancer-specific survival rate as patients who underwent open resection. © The American Society of Colon and Rectal Surgeons.
Persistent Identifierhttp://hdl.handle.net/10722/83861
ISSN
2015 Impact Factor: 3.739
2015 SCImago Journal Rankings: 2.077
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLaw, WLen_HK
dc.contributor.authorLee, YMen_HK
dc.contributor.authorChoi, HKen_HK
dc.contributor.authorSeto, CLen_HK
dc.contributor.authorHo, JWCen_HK
dc.date.accessioned2010-09-06T08:46:05Z-
dc.date.available2010-09-06T08:46:05Z-
dc.date.issued2006en_HK
dc.identifier.citationDiseases Of The Colon And Rectum, 2006, v. 49 n. 8, p. 1108-1115en_HK
dc.identifier.issn0012-3706en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83861-
dc.description.abstractPURPOSE: This study was designed to compare the outcomes of laparoscopic anterior resection with open operation for mid and upper rectal cancer. METHODS: A total of 265 patients who underwent elective laparoscopic or open anterior resection for cancer of the mid and upper rectum from June 2000 to December 2004 were included. Data about the patients' demographics, operative details, postoperative outcome, and disease status were collected prospectively. Comparison of the outcome between laparoscopic and open resection was performed. RESULTS: The median age of the 265 patients was 69 (range, 27-91) years, and laparoscopic anterior resection was performed in 98 patients (37 percent). There was no difference in the age, gender, comorbidities, and level of tumor between the two groups. The operating time was longer in the laparoscopic group (200 vs. 127 minutes; P < 0.01), but the blood loss was less (200 vs. 250 ml; P = 0.027). The overall operative mortality was 1.8 percent, and the complication rate was 27.9 percent. Significantly more patients with early diseases (Stage I and Stage II) were operated with laparoscopic approach. There was no difference in the mortality or morbidity between the two groups. Anastomotic leakage occurred in five patients with open resection and one with laparoscopic resection (P = 0.418). Patients with laparoscopic resection had an earlier return of bowel function and earlier resumption of diet as well as a shorter median hospital stay (7 vs. 8 days; P < 0.001). With the median follow-up of the surviving patients for 21.2 months, the three-year local recurrence rates for those with open and laparoscopic resection were 4.9 and 3.3 percent, respectively (P = 0.513). In patients with Stage I and Stage II disease, the three-year cancer-specific survivals for open and laparoscopic resection were 89.8 and 88.6 percent, respectively (P = 0.882), whereas those of patients with Stage III disease were 65.6 and 55.5 percent, respectively (P = 0.911). CONCLUSIONS: Laparoscopic anterior resection for mid and proximal rectal cancer is a safe option with short-term advantages compared with open operation. The oncologic outcomes of patients who underwent laparoscopic anterior resection were not compromised, with similar local recurrence rate and the cancer-specific survival rate as patients who underwent open resection. © The American Society of Colon and Rectal Surgeons.en_HK
dc.languageengen_HK
dc.publisherSpringer New York LLC. The Journal's web site is located at http://www.springerlink.com/content/0012-3706/en_HK
dc.relation.ispartofDiseases of the Colon and Rectumen_HK
dc.rightsThe original publication is available at www.springerlink.com-
dc.subjectLaparoscopic anterior resectionen_HK
dc.subjectRectal canceren_HK
dc.subject.meshDigestive System Surgical Procedures - methods-
dc.subject.meshLaparoscopy-
dc.subject.meshNeoplasm Recurrence, Local-
dc.subject.meshRectal Neoplasms - surgery-
dc.subject.meshStatistics, Nonparametric-
dc.titleLaparoscopic and open anterior resection for upper and mid rectal cancer: An evaluation of outcomesen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-3706&volume=49&issue=8&spage=1108&epage=1115&date=2006&atitle=Laparoscopic+and+open+anterior+resection+for+upper+and+mid+rectal+cancer:+an+evaluation+of+outcomesen_HK
dc.identifier.emailLaw, WL: lawwl@hkucc.hku.hken_HK
dc.identifier.authorityLaw, WL=rp00436en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s10350-006-0551-0en_HK
dc.identifier.pmid16763756-
dc.identifier.scopuseid_2-s2.0-33747089227en_HK
dc.identifier.hkuros135655en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-33747089227&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume49en_HK
dc.identifier.issue8en_HK
dc.identifier.spage1108en_HK
dc.identifier.epage1115en_HK
dc.identifier.isiWOS:000239999000002-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLaw, WL=7103147867en_HK
dc.identifier.scopusauthoridLee, YM=8521465600en_HK
dc.identifier.scopusauthoridChoi, HK=7404339913en_HK
dc.identifier.scopusauthoridSeto, CL=7004637406en_HK
dc.identifier.scopusauthoridHo, JWC=7402649983en_HK
dc.identifier.citeulike885276-

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