title: Laparoscopic surgery for rectal cancer: a single-centre experience of 120 cases.
abstract: BACKGROUND
  For colorectal surgeons, laparoscopic rectal cancer surgery poses a new challenge. The defence of the questionable oncological safety tempered by the impracticality of the long learning curve is rapidly fading. As a unit specialising in minimally invasive surgery, we have routinely undertaken rectal cancer surgery laparoscopically since 2005.
  
  
  METHODS
  Patients undergoing surgery for rectal cancer between June 2005 and February 2010 were retrospectively reviewed from a prospectively maintained colorectal cancer database.
  
  
  RESULTS
  One hundred and thirty patients underwent surgery for rectal cancer during the study period. One hundred and twenty patients had a laparoscopic resection, six were converted to open (conversion rate 5%) and 10 had a planned primary open procedure. Fifty four were low rectal tumours and 76 were upper rectal tumours. One hundred and thirteen patients had an anterior resection (87%), 17 patients an abdomino-perineal resection (13%) and 62 of the 130 patients (47.6%) had neoadjuvant radiotherapy. The median lymph node retrieval rate was 12 (9-14), five patients (3.8%) had a positive circumferential margin and the clinical anastomotic leak rate was 3.8% (n = 5 patients). There was no significant difference in the stated parameters for neoadjuvant versus non-neoadjuvant patients and for upper versus lower rectal tumours. Ninety three percent of mesorectal excision specimens were complete on pathological assessment.
  
  
  CONCLUSIONS
  During the study period, 92% of rectal cancers underwent a laparoscopic resection with low rates of morbidity and acceptable short-term oncological outcomes. This data supports the view that laparoscopic surgery for rectal cancer can be safely delivered in mid-volume centres by surgeons who have completed the learning curve for laparoscopic colorectal surgery.
authors.affiliation: Minimally Invasive Surgical Unit, Division of Colorectal Surgery, Adelaide and Meath Incorporating the National Childrens Hospital, Tallaght, Dublin 24, Ireland. goodd@tcd.ie
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Good
authors.forename: James M
authors.initials: JM
authors.lastname: O'Riordan
authors.forename: Diarmaid
authors.initials: D
authors.lastname: Moran
authors.forename: Frank B
authors.initials: FB
authors.lastname: Keane
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Eguare
authors.forename: Diarmuid S
authors.initials: DS
authors.lastname: O'Riordain
authors.forename: Paul C
authors.initials: PC
authors.lastname: Neary
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult