title: Laparoscopic surgery after endoscopic resection for rectal cancer and neuroendocrine tumors.
abstract: BACKGROUND
  Endoscopic resection (ER) of tumors causes inflammation, edema, fibrosis, and adhesions in the surrounding tissue. However, little is known about the effect of ER on subsequent laparoscopic surgery for rectal tumors. The objective of this retrospective study was to analyze the effect of ER on subsequent laparoscopic surgery for rectal tumors.
  
  
  METHODS
  Twenty-eight patients underwent laparoscopic surgery for rectal adenocarcinoma with submucosal invasion or a rectal neuroendocrine tumor at our hospital between January 2005 and December 2012. A group of 14 patients who underwent laparoscopic surgery with previous ER was compared to a group of 14 patients who underwent laparoscopic surgery without previous ER.
  
  
  RESULTS
  Though most fibrosis involved the submucosa after polypectomy and endoscopic mucosal resection, fibrosis after endoscopic submucosal dissection involved the muscularis propria in two patients, and the subserosa in one patient. There were no statistically significant differences in clinical outcomes between the groups.
  
  
  CONCLUSIONS
  Laparoscopic surgery after ER for rectal tumors is safe and feasible. Laparoscopic surgery is the reasonable first-choice for radical treatment of rectal tumors after ER.
authors.affiliation: Department of Surgery, Nara Medical University, 840 Shijocho, Kashihara, Nara, 634-8522, Japan, inotaka@naramed-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Inoue
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Nakamura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ueda
authors.forename: Naoto
authors.initials: N
authors.lastname: Nishigori
authors.forename: Keijiro
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Obara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakamoto
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Fumikazu
authors.initials: F
authors.lastname: Koyama
authors.forename: Hisao
authors.initials: H
authors.lastname: Fujii
mesh_terms: D003082:Colectomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000175:diagnosis / Q000601:surgery*; D012004:Rectal Neoplasms / Q000175:diagnosis / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies