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KMID : 0978820070100010028
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Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2007 Volume.10 No. 1 p.28 ~ p.33
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Laparoscopic versus Open Rectal Surgery after Neoadjuvant Chemoradiation for Rectal Cancer
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Park Se-Hun
Oho Jae-Hwan
Baek Jeong-Heum
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Abstract
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Purpose: This study aimed to compare the efficacy and safety of laparoscopic surgery and open surgery as treatment for rectal cancer after neoadjuvant chemoradiation.
Methods: Patients with mid- to lower rectal cancer underwent either laparoscopic surgery (22 pts) or open surgery (37 pts) after neoadjuvant chemoradiation.
Results: The mean age of patients was 58.3 in the laparoscopic surgery group (LG) and 57.1 in the open surgery group (OG). There was no significant difference (p＜0.05) between the two groups regarding gender age, the body mass index, the ASA score, associated disease and the need for transfusion. The overall conversion rate was 9% (n=2) in the LG. The mean operation time was 287 minutes and this was 208 minutes in the LG and the OG, respectively (p=0.004). The time to passing gas after surgery was 1.5 days and 2.2 days in the LG and the OG, respectively (p=0.004). There was no significant difference between the two groups regarding the distal margin of the resected specimen, the number of dissected lymph node, morbidity, time to the first meal after surgery and the mean hospital stay. No serious complication or death was reported for the two groups.
Conclusion: There is no evidence that laparoscopic rectal surgery after neoadjuvant therapy is inadequate, according to our results and with following the principles of cancer surgery. Sufficient lymph node dissection and a tumor free distal margin of resected bowel were accomplished with laparoscopic surgery. Laparoscopic surgery is safe and feasible, and it is similar to the conventional approach concerning to the morbidity. A future study with a larger number of cases and long-term follow up will be necessary to confirm the value of laparoscopic surgery after neoadjuvant chemoradiation.
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KEYWORD
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Rectal cancer, Neoadjuvant therapy, Chemoradio therapy, Laparoscopic surgery
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