|
KMID : 0371420180940010026
|
|
Annals of Surgical Treatment and Research
2018 Volume.94 No. 1 p.26 ~ p.35
|
|
|
Long-term outcomes after Natural Orifice Specimen Extraction versus conventional laparoscopy-assisted surgery for rectal cancer: a matched case-control study
|
|
Park Jun-Seok
Kang Hyun
Park Soo-Yeun
Kim Hye-Jin
Lee In-Taek
Choi Gyu-Seog
|
|
|
Abstract
|
|
|
Purpose: The aim of this study was to compare the long-term outcomes of total laparoscopic surgery with Natural Orifice Specimen Extraction (NOSE) with those for conventional laparoscopy (CL)-assisted surgery for treating rectal cancers.
Methods: We reviewed the prospectively collected records of 844 patients (163 NOSE and 681 CL) who underwent curative surgery for mid- or upper rectal cancers from January 2006 to November 2012. We applied propensity score analyses and compared oncological outcomes for the NOSE and CL groups in a 1:1 matched cohort.
Results: After propensity score matching, each group included 138 patients; the NOSE and CL groups did not differ significantly in terms of baseline clinical characteristics. The median follow-up was 57.7 months (interquartile range, 42.4?82.5 months). The combined 5-year local recurrence rate for all tumor stages was 4.1% (95% confidence interval [CI], 0.9%?7.4%) in the NOSE group and 3.0% (95% CI, 0%?6.3%) in the CL group (P = 0.355). The combined 5-year disease-free survival rates for all stages were 89.3% (95% CI, 84.3%?94.3%) in the NOSE group and 87.3% (95% CI, 81.8%?92.9%) in the CL group (P = 0.639). The postoperative mean fecal incontinence scores at 6, 12, and 24 months were similar between the 2 groups.
Conclusion: In our experience, NOSE for mid- and upper rectal cancer had acceptable long-term oncologic outcomes comparable to those of conventional minimal invasive surgery and seems to be a safe alternative to reduce access trauma.
|
|
|
KEYWORD
|
|
|
Natural Orifice Endoscopic Surgery, Survival, Rectal cancer, Laparoscopy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|