Long-term outcomes of patients undergoing curative laparoscopic surgery for mid and low rectal cancer.
OBJECTIVE
The use of laparoscopy surgery in the management of rectal cancer is controversial, especially in the mid and low rectum. The aim of this study was to determine oncologic and long-term outcomes after laparoscopic and hand-assisted laparoscopic surgery for mid and low rectal cancer.


METHODS
Between January 1999 and December 2006, 185 patients had surgery for rectal cancer; 103 these patients had mid and low rectal cancer. The source of data was inpatient/outpatient medical records. Telephone interviews were conducted for all patients. Actuarial survival was calculated with use of the Kaplan-Meier method.


RESULTS
Hand-assisted laparoscopic surgery was performed in 58 (56.3%) patients, and pure laparoscopic surgery in 45 (43.7%) patients. Mean follow-up time was 42.1 months. The conversion rate was 2.9%. All specimen margins were negative. The anastomotic leak rate was 7.8% (n = 8). There was no 30-day mortality. Local recurrence rate was 5% at five years. Overall survival was 91% and disease-free survival was 73.1% at five years.


CONCLUSIONS
Laparoscopic surgical techniques for mid and low rectal cancer seem safe and feasible with acceptable oncologic and long-term outcomes. Further studies, comparing laparoscopic and open methods, are warranted.
Milsom
Jeffrey W
JW
New York Presbyterian Hospital/Weill Cornell Medical College, New York, New York, USA. jwm2001@med.cornell.edu
de Oliveira
Olival
O
Trencheva
Koiana I
KI
Pandey
Sushil
S
Lee
Sang W
SW
Sonoda
Toyooki
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult