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LAPAROSCOPIC VERSUS OPEN TOTAL MESORECTAL EXCISION: A CASE‐CONTROL STUDY
Author(s) -
Breukink S. O.,
Pierie J. P. E. N.,
Grond A. J.,
Hoff C.,
Wiggers T.,
Meijerink W. J. H. J.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04131_7.x
Subject(s) - medicine , total mesorectal excision , surgery , colorectal cancer , randomized controlled trial , anastomosis , general surgery , cancer
Purpose Because definitive long‐term results are not yet available, the oncological safety of laparoscopic surgery for treatment of rectal cancer remains unproven. The aim of this prospective non‐randomized study was to assess the feasibility and short‐term outcome of laparoscopic total mesorectal excision (LTME) after 25–30 Gy preoperative radiotherapy and to compare the results with a matched‐control group of open TME (OTME). Methodology A series of 41 patients with primary rectal cancer underwent LTME for rectal cancer and were matched with a historical control group of 41 patients who underwent OTME. Both groups received preoperative short‐term radiotherapy. Results There was no mortality in the LTME group and 2% mortality in the OTME group. The overall postoperative morbidity was 37% in the LTME group and 51% in the OTME group, including an anastomotic leakage of 9 and 14% in the LTME and OTME groups respectively. A positive circumferential margin was found in 7% of patients in the LTME group and in 12% of the patients in the OTME group. Conclusion This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique.