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Minimally invasive versus open total mesorectal excision for rectal cancer: Long-term results from a case-matched study of 633 patients.
Surgery. 2015 Jun; 157(6):1121-9.S

Abstract

BACKGROUND

This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME.

METHODS

This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment.

RESULTS

A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups.

CONCLUSION

We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications.

Authors+Show Affiliations

Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.Section of Colon and Rectal Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea. Electronic address: namkyuk@yuhs.ac.

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article

Language

eng

PubMed ID

25737005

Citation

Cho, Min Soo, et al. "Minimally Invasive Versus Open Total Mesorectal Excision for Rectal Cancer: Long-term Results From a Case-matched Study of 633 Patients." Surgery, vol. 157, no. 6, 2015, pp. 1121-9.
Cho MS, Kim CW, Baek SJ, et al. Minimally invasive versus open total mesorectal excision for rectal cancer: Long-term results from a case-matched study of 633 patients. Surgery. 2015;157(6):1121-9.
Cho, M. S., Kim, C. W., Baek, S. J., Hur, H., Min, B. S., Baik, S. H., Lee, K. Y., & Kim, N. K. (2015). Minimally invasive versus open total mesorectal excision for rectal cancer: Long-term results from a case-matched study of 633 patients. Surgery, 157(6), 1121-9. https://doi.org/10.1016/j.surg.2015.01.010
Cho MS, et al. Minimally Invasive Versus Open Total Mesorectal Excision for Rectal Cancer: Long-term Results From a Case-matched Study of 633 Patients. Surgery. 2015;157(6):1121-9. PubMed PMID: 25737005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Minimally invasive versus open total mesorectal excision for rectal cancer: Long-term results from a case-matched study of 633 patients. AU - Cho,Min Soo, AU - Kim,Chang Woo, AU - Baek,Se Jin, AU - Hur,Hyuk, AU - Min,Byung Soh, AU - Baik,Seung Hyuk, AU - Lee,Kang Young, AU - Kim,Nam Kyu, Y1 - 2015/02/28/ PY - 2014/10/05/received PY - 2015/01/01/revised PY - 2015/01/20/accepted PY - 2015/3/5/entrez PY - 2015/3/5/pubmed PY - 2015/7/24/medline SP - 1121 EP - 9 JF - Surgery JO - Surgery VL - 157 IS - 6 N2 - BACKGROUND: This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. METHODS: This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. RESULTS: A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. CONCLUSION: We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications. SN - 1532-7361 UR - https://www.unboundmedicine.com/medline/citation/25737005/Minimally_invasive_versus_open_total_mesorectal_excision_for_rectal_cancer:_Long_term_results_from_a_case_matched_study_of_633_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0039-6060(15)00026-4 DB - PRIME DP - Unbound Medicine ER -