Can adequate lymphadenectomy be obtained by laparoscopic resection in rectal cancer? Results of a case-control study in 200 patients.
OBJECTIVE
The aim of this study is to compare pathological findings in rectal cancer specimens obtained by laparoscopy or laparotomy.


METHODS
Bowel length, distal and circumferential margins, and number of total and positive nodes harvested were prospectively recorded in specimens obtained from 100 consecutive patients who had a laparoscopic total mesorectal excision for cancer. These data were compared with those extracted from a well-matched group of 100 patients who had an open procedure.


RESULTS
The mean length of the specimens was 31.04 cm in the case group and 29.45 cm in the control group (not significant (NS)). All distal margins in both groups were negative. The circumferential margin was positive in four cases in the case group and nine cases in the control group (NS). The mean number of lymph nodes harvested was 13.76 nodes/patient in the case group and 12.74 nodes/patient in the control group (NS). The mean number of involved lymph nodes was 1.18 node/case in the case group and 1.96 node/case in group 2 (NS).


CONCLUSIONS
There is no difference between laparoscopic or open approaches concerning specimen's length, distal margin, circumferential margin, and total and positive lymph nodes. Laparoscopic rectal resection is not only technically feasible but it seems also oncologically safe.
Sara
Samer
S
Department of Colorectal Surgery, University Hospital, Grenoble cedex, France.
Poncet
Gilles
G
Voirin
David
D
Laverriere
Marie-Hélène
MH
Anglade
Daniel
D
Faucheron
Jean-Luc
JL
D003082:Colectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008197:Lymph Node Excision / Q000379:methods*; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome