Evolution of minimally invasive surgery for rectal cancer: update from the national cancer database

Gilmore, Brian F.; Adam, Mohamed A.; Rhodin, Kristen E.; Turner, Megan C.; Ezekian, Brian; Mantyh, Christopher R.; Migaly, John

doi:10.1007/s00464-020-07393-y

Cited by 10 publications

(7 citation statements)

References 28 publications

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“…Colorectal cancer is the third most common type of cancer worldwide and continues to be a major cause of morbidity and mortality. The use of minimally invasive surgical methods for the treatment of colon cancer has increased in recent years due to the growing evidence of equivalent short-term surgical and oncologic outcomes [3]. In our study, we aimed to assess our short-term surgical and oncological results for mid and low rectal cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…This indicates that the higher number of lymph nodes removed from laparoscopic patients who received preoperative therapy cannot be completely explained by the relatively higher proportion of preoperative therapy and higher response rate in the open surgery group, and that laparoscopy does not have an adverse impact on short-term oncological outcomes. In a metaanalysis [2] comparing the short-and long-term outcomes of these surgical approaches after neoadjuvant therapy in rectal cancer, as well as in many articles comparing removed lymph nodes, CRM, DRM, it was reported that the outcomes were significantly better in the laparoscopic group [3] or were similar between the groups [2,[12][13][14][15][16][17].…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic surgery is steadily replacing open surgery because it involves less blood loss, smaller surgical incisions, faster recovery, and shorter hospital stay [2]. However, the adoption of laparoscopic surgery for rectal cancer has been slower due to the difficulty of pelvic dissection and resulting concerns about the ability to perform TME equivalent to open surgery [3]. The aim of this study was to compare short-term surgical and oncologic outcomes of patients who underwent open and laparoscopic surgery for the treatment of the mid and low rectal cancer.…”

Section: Introductionmentioning

confidence: 99%

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Short-term results in mid and low rectal cancer with laparoscopic and open surgery

2022

Ann Clin Anal Med

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Aim: The aim of this study was to compare rectal cancer patients who underwent open and laparoscopic surgery in terms of their short-term surgical and oncological outcomes. Material and Methods: We retrospectively evaluated data of 71 patients with mid and low rectal cancer who underwent elective curative laparoscopic and open total mesorectal excision between January 2017 and December 2019. Results: The operative time was longer ( 192 min. vs 173 min., p=0.059), the estimated blood loss was less (75 ml vs 150 ml, p=0,03), and the length of incision was obviously shorter in the laparoscopy group ( 5 cm vs 18 cm, p=0.01). There was no mortality in any of the groups. The overall morbidity rate was 25% in the open group and 17.94% in the laparoscopy group (p=0.469). Revision surgery was needed in 9.38% of the patients in the open group, 12.8% in the laparoscopy group (p=0.648). In the laparoscopy group, the cause of revision surgery was anastomotic leak for all patients. The median lymph node number was higher in the laparoscopy group. There was no significant difference in terms of surgical margins, surgical methods, time of initiation of oral intake and first flatus, and hospital stay. During the follow-up period, 2 patients (6.25%) in the open group had a local recurrence, and five patients (12.8%) in the laparoscopy group had distant metastasis. Discussion: Laparoscopic surgery is a safe and effective method that can be used in the treatment of mid-low rectal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Short-term results in mid and low rectal cancer with laparoscopic and open surgery

2022

Ann Clin Anal Med

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“…There are few literatures on comparable nationwide data between countries. A study based on the 2010-2015 National Cancer Database in the United States reported that 51% of rectal cancer patients had minimally invasive surgery [5]. Japan Society for Endoscopic Surgery reported that a penetration rate of laparoscopic surgery for CRC was 58 % in 2013 [6].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Surgery for Colorectal Cancer in Korea: Nationwide Data from 2013 to 2018

Park

Lee

2020

Cancer Res Treat

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PurposeWe report nationwide data on the current status of laparoscopic surgery for colorectal cancer (CRC) in Korea.Materials and MethodsNationwide data of patients who underwent surgery for CRC from 2013 to 2018 were obtained from the Health Insurance Review & Assessment Service database. Data and trends of laparoscopy use for colorectal resection over six years were examined. ResultsIn Korea, a total of 117,320 patients underwent surgical resection for CRC from 2013 to 2018. The proportion of laparoscopic resection increased from 64.9% in 2013 to 78.5% in 2018. The rate of laparoscopic resection for colon cancer increased from 64.7% in 2013 to 77.4% in 2018. For rectal cancer, the rate of laparoscopic resection increased from 65.4% to 81.6%. Males accounted for 59.8% of all patients, but females surpassed males at over 80 years of age. The age of peak incidence was in the 60s for males and in the 70s for females. A steady increase in the number of patients undergoing surgery for CRC was observed over 80 years of age.ConclusionThe laparoscopic penetration rate for CRC in Korea continued to increase annually and reached 78.5% in 2018.

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“…Review of non-randomized data from the National Cancer Database (NCDB) including 18,765 patients demonstrated equivalence of the MIS and open procedures [78]. Long-term survival outcomes of ACOSOG Z6051, ALaCaRT, and NCDB have demonstrated equivalence between the two techniques [79][80][81][82][83][84][85].…”

Section: Oncologic Outcomesmentioning

confidence: 99%

Proctectomy for Rectal Cancer

Migaly

Weiss

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Removal of the rectum and mesorectum should routinely be performed using sharp dissection in the plane surrounding the mesorectal fascia to ensure removal of all mesorectum at risk for nodal spread.• The quality of the mesorectum should be graded and the non-peritonealized radial margin of resection inked so that the pathologist can measure circumferential margin status. • Multidisciplinary decision-making regarding the use of neoadjuvant and/or adjuvant therapy improves outcomes in patients with rectal cancer. • Functional derangements are common following restorative proctectomy. Minimizing these derangements should be kept in mind when choosing type of neorectal reservoir and/or whether to perform anastomosis. Patients suffering from anterior resection syndrome may benefit from ongoing support and counseling. • Adherence to oncologic principles should be maintained when performing proctectomy using minimally invasive surgical techniques. • Locally advanced rectal cancer extending into other organs requires expertise at dissection outside of the usual tissue planes. With proper planning and combined surgery with other specialties, patients may enjoy good long-term outcomes. • Pelvic failure rates have improved significantly over the past several decades as a result of increased attention to detail during proctectomy and the increased use of neoadjuvant therapy.

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Evolution of minimally invasive surgery for rectal cancer: update from the national cancer database

Cited by 10 publications

References 28 publications

Short-term results in mid and low rectal cancer with laparoscopic and open surgery

Short-term results in mid and low rectal cancer with laparoscopic and open surgery

Laparoscopic Surgery for Colorectal Cancer in Korea: Nationwide Data from 2013 to 2018

Proctectomy for Rectal Cancer

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