title: Long-term outcome of laparoscopic total mesorectal excision for middle and low rectal cancer.
abstract: This study aimed to assess the feasibility and long-term outcome of laparoscopic total mesorectal excision for middle and lower rectal cancer. Retrospective assessment was performed on 612 patients with middle and low rectal cancer in the surgery department of our hospital. Three-hundred and three patients underwent laparoscopic total mesorectal excision (LTME), and 309 patients underwent open TME (OTME). All the data regarding patient details, operative variables and the short- and long-term outcomes were collected and compared. The sphincter-preserving rates of the two groups were similar. The conversion rate in LTME was 2.31% (seven cases). Fourteen cases (6.67%) of protective diverting stoma were fashioned in the LTME group compared with 57 cases (26.64%) in the OTME group. The postoperative morbidity was the same in these two groups, while the postoperative period until bowel movement and hospital discharge was shorter in the LTME group (P < 0.01). The median follow-up period was 34 (6-81) months for the LTME group and 36 (6-81) months for the OTME group. Local recurrence rates, the five-year disease-free survival rate and the five-year overall survival rate showed no difference between the two groups. Laparoscopic surgery is feasible and safe in patients with middle and lower rectal cancer and can provide favorable short-term and long-term outcomes.
authors.affiliation: Department of Surgery, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197 Ruijin er Road, Shanghai, China. fb11427@rjh.com.cn
authors.forename: Min-Hua
authors.initials: MH
authors.lastname: Zheng
authors.forename: Bo
authors.initials: B
authors.lastname: Feng
authors.forename: Chun-Yun
authors.initials: CY
authors.lastname: Hu
authors.forename: Ai-Guo
authors.initials: AG
authors.lastname: Lu
authors.forename: Ming-Liang
authors.initials: ML
authors.lastname: Wang
authors.forename: Jian-Wen
authors.initials: JW
authors.lastname: Li
authors.forename: Wei-Guo
authors.initials: WG
authors.lastname: Hu
authors.forename: Lu
authors.initials: L
authors.lastname: Zang
authors.forename: Zhi-Hai
authors.initials: ZH
authors.lastname: Mao
authors.forename: Tao-Tao
authors.initials: TT
authors.lastname: Dong
authors.forename: Feng
authors.initials: F
authors.lastname: Dong
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
authors.forename: Jun-Jun
authors.initials: JJ
authors.lastname: Ma
authors.forename: Ya-Ping
authors.initials: YP
authors.lastname: Zong
authors.forename: Michael Ka Wah
authors.initials: MK
authors.lastname: Li
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000379:methods*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D012004:Rectal Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome