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Laparoscopic versus open total mesorectal excision: a case-control study.

S O Breukink·J P E N Pierie·A J K Grond·C Hoff·T Wiggers·W J H J Meijerink
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Abstract

BACKGROUND AND AIMS: 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-randomised 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). MATERIALS AND METHODS: 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 compared with open surgery.

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AdultAgedAged, 80 and overAnastomosis, SurgicalCase-Control StudiesDigestive System Surgical ProceduresFeasibility StudiesFemaleFollow-Up StudiesHumansLaparoscopyMaleMiddle AgedNeoplasm StagingProspective StudiesRectal NeoplasmsSurgical StomasSurvival AnalysisTreatment OutcomeJournal Article

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S O Breukink, J P E N Pierie, A J K Grond, C Hoff, T Wiggers, W J H J Meijerink. 2005-03-31. Laparoscopic versus open total mesorectal excision: a case-control study.. https://doi.org/10.1007/s00384-004-0715-0

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