title: Clinical and oncologic safety of laparoscopic surgery for obstructive left colorectal cancer following transanal endoscopic tube decompression.
abstract: BACKGROUND
  Little information has been available concerning the safety of laparoscopic resection of obstructive colorectal cancer after transanal endoscopic tube decompression (TETD). The aim of this study was to assess the short- and long-term outcomes of laparoscopic surgery following TETD for such advanced colorectal cancer.
  
  
  METHODS
  A retrospective review was performed of 40 patients with obstructive left colorectal cancer whose distended bowels were treated with TETD before laparoscopic surgery, between January 2001 and March 2011 (TETD group). The elective surgery resulted in potentially curative resection of the tumor in all cases. Their clinical records were compared to those of 80 matched controls with nonobstructive left colorectal cancer resected laparoscopically during the same period (control group).
  
  
  RESULTS
  Operative time, blood loss, and the rate of conversion to laparotomy were comparable between the two groups. There were no significant between-group differences in morbidity rates. Five-year overall survival rates in the TETD and control groups were 71.9 and 75.4%, respectively, with no statistical difference. Disease-free survival rates after 5 years were also similar (TETD group, 64.5% vs. control group, 66.3%). There were no significant differences between the two groups in recurrence rates and patterns.
  
  
  CONCLUSIONS
  These results suggest that laparoscopic surgery following TETD is clinically and oncologically safe and could be a treatment of choice for obstructive left colorectal cancer.
authors.affiliation: Department of Digestive Surgery, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya 466-8650, Japan. shingu@nagoya2.jrc.or.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shingu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Eiji
authors.initials: E
authors.lastname: Sakamoto
authors.forename: Shunichiro
authors.initials: S
authors.lastname: Komatsu
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kurumiya
authors.forename: Shinji
authors.initials: S
authors.lastname: Norimizu
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Taguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications* / Q000601:surgery*; D019299:Decompression, Surgical / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D012189:Retrospective Studies; D016896:Treatment Outcome
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