Short- and Long-term Outcomes of Laparoscopic Total Mesenteric Excision for Neuroendocrine Tumors of the Rectum.
BACKGROUND
To our knowledge, no studies to date have assessed the short- and long-term outcomes of laparoscopic total mesenteric excision in patients with neuroendocrine tumors of the rectum.


OBJECTIVE
The purpose of this study was to investigate the short- and long-term outcomes of patients who underwent laparoscopic rectal resection plus total mesenteric excision for rectal neuroendocrine tumors at our institution.


METHODS
This was a single center, retrospective study.


METHODS
The study was conducted at a tertiary care facility.


METHODS
Eight-two patients with neuroendocrine tumors who underwent rectal resection with total mesenteric excision, 77 laparoscopically, between June 2005 and August 2015 were included.


METHODS
Laparoscopic rectal resection and total mesenteric excision were the study interventions.


METHODS
Demographic characteristics and surgical and postoperative outcomes were measured.


RESULTS
Median tumor size was 8.8 mm (range, 3.0-35.0 mm); 63.6% of tumors were located in the lower rectum, with the median distance from the tumor to the anal verge being 50.0 mm (range, 20.0-130.0 mm). Anal preservation was achieved in all of the patients. Anastomotic leakage occurred in 5 patients (6.5%), but there were no deaths. Seventy-one patients (92.2%) had tumor invasion confined to the submucosa. Lymph node metastasis was present in 29 patients (37.7%), including 26 (33.8%) with perirectal and 5 (6.5%) with lateral lymph node metastasis. The median follow-up period in 59 patients was 42 months (range, 11-113 months), and the 3-year overall survival rate was 97.8%.


CONCLUSIONS
The study was limited by its single-center, retrospective analysis.


CONCLUSIONS
Laparoscopic rectal resection with total mesenteric excision is safe in patients with rectal neuroendocrine tumors, with good short- and long-term outcomes. Because rectal neuroendocrine tumors are smaller and show superficial invasion, the rate of anal preservation may be high.
Department of Gastroenterological Surgery, Gastroenterological Center, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Yukiko
Y
Takatsu
Yosuke
Y
Fukunaga
Toshiya
T
Nagasaki
Takashi
T
Akiyoshi
Tsuyoshi
T
Konishi
Yoshiya
Y
Fujimoto
Satoshi
S
Nagayama
Masashi
M
Ueno
D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008643:Mesentery / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome