title: Short-term results of laparoscopic surgery after preoperative chemoradiation for clinically staged T3 and T4 rectal cancer.
abstract: BACKGROUND
  The feasibility of laparoscopic surgery for clinically staged T3 and T4 rectal cancer has not been clearly defined specifically in cases following preoperative chemoradiation therapy (CRT). Our aim was to investigate the feasibility of laparoscopic surgery after preoperative CRT for clinically staged T3 and T4 rectal cancer.
  
  
  METHODS
  Between May 2003 and June 2009, 57 patients (T3: n = 50, T4: n = 7) who underwent preoperative CRT for rectal cancer were identified. Forty-three patients with laparoscopic surgery (Lap group) were compared with 14 patients who underwent open surgery (Open group). Perioperative data including postoperative morbidity were assessed between the two groups.
  
  
  RESULTS
  All patients underwent complete laparoscopic operations, and none was converted to laparotomy. Operating time was longer in the Open group (331 vs 375 min, P < 0.01). Blood loss was lower in the Lap group (160 vs 316 mL, P < 0.01). Lymph node harvest and morbidity rate were similar in both groups. The distal tumor margin was negative in all patients. No patients had perioperative mortality associated with surgery after CRT.
  
  
  CONCLUSIONS
  Laparoscopic surgery after preoperative CRT is a feasible and a safe option for T3 and T4 rectal cancer compared to conventional open surgery.
authors.affiliation: Department of Surgery, Tokushima University Hospital, Tokushima, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Hotchi
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Shimada
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Kurita
authors.forename: Takashi
authors.initials: T
authors.lastname: Iwata
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sato
authors.forename: Shinya
authors.initials: S
authors.lastname: Morimoto
authors.forename: Kozo
authors.initials: K
authors.lastname: Yoshikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Higashijima
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Miyatani
authors.forename: Chie
authors.initials: C
authors.lastname: Mikami
authors.forename: Hideya
authors.initials: H
authors.lastname: Kashihara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D059248:Chemoradiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D057234:Preoperative Period; D012004:Rectal Neoplasms / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome