Laparoscopic total mesorectal excision

Pikarsky, Alon J.; Rosenthal, Raúl J.; Weiss, Eric G.; Wexner, Steven D.

doi:10.1007/s00464-001-8250-3

Cited by 69 publications

(40 citation statements)

References 44 publications

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“…The LAPR was performed as described by Pikarsky et al [8] A circumferential resection margin (CRM) of ≤ 2 mm was considered positive. [9] Perioperative mortality was defined as deaths taking place while the patient was still hospitalized.…”

Section: Methodsmentioning

confidence: 99%

Feasibility of laparoscopic abdomino - perineal resection for large - sized anorectal cancers : A single - institution experience of 59 cases

Shukla¹,

Barreto²,

Hawaldar³

et al. 2009

Indian J Med Sci

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Section: Methodsmentioning

confidence: 99%

Feasibility of laparoscopic abdomino - perineal resection for large - sized anorectal cancers : A single - institution experience of 59 cases

Shukla¹,

Barreto²,

Hawaldar³

et al. 2009

Indian J Med Sci

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“…Current evidence supports the concept of laparoscopic colonic resection over the traditional open modalities with known improvements in short-term outcomes, in addition to equivalent long-term results, when compared to open surgery [12,13] . In the short-term patients were noted to have faster recoveries, earlier feeding, decreased overall morbidity, earlier return of bowel function and decreased amounts of intraoperative blood loss [14,15] . In the intermediate term there was an earlier return to work.…”

Section: Introductionmentioning

confidence: 99%

Is laparoscopic rectal surgery really not non-inferior?

O'Donohue¹,

Warren²,

Chow³

2018

MIS

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Laparoscopic rectal surgery has gained popularity over the last 20 years. Currently there are still questions surrounding the safety and efficacy of this technique as compared to the traditional open modalities. To date, despite the initial enthusiasm for laparoscopic rectal surgery this technique is yet to reach non-inferiority in trials when compared to open resection. This review article discusses the current evidence exploring the value of laparoscopic rectal surgery. It will discuss its evolution over the last 20 years, exploring all the major randomised control trials and their results. It is our belief that laparoscopic rectal surgery for malignancy is not non-inferior to conventional open surgery.

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“…Therefore, total mesorectal excision has become gold standard surgical strategy to treat rectal malignancies [10,11] . Laparoscopic total mesorectal excision (LTME) offers several advantages over conventional and orthodox open total mesorectal excision (OTME) such as reduced blood loss, faster recovery, reduced postoperative pain score, early feeding, early return to normal activities and a reduced risk of postoperative complications [12][13][14][15][16] . However, these advantages of LTME can only be availed optimally by colorectal surgeons when its oncological viability is proven on scientific grounds.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of oncological outcomes following laparoscopicvsopen total mesorectal excision

Sajid

Ahamd

Miles

et al. 2014

WJGE

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AIM:To systematically analyze the randomized trials comparing the oncological and clinical effectiveness of laparoscopic total mesorectal excision (LTME) vs open total mesorectal excision (OTME) in the management of rectal cancer. METHODS:Published randomized, controlled trials comparing the oncological and clinical effectiveness of LTME vs OTME in the management of rectal cancer were retrieved from the standard electronic medical databases. The data of included randomized, controlled trials was extracted and then analyzed according to the principles of meta-analysis using RevMan ® statistical software. The combined outcome of the binary variables was expressed as odds ratio (OR) and the combined outcome of the continuous variables was presented in the form of standardized mean difference (SMD). RESULTS:Data from eleven randomized, controlled trials on 2143 patients were retrieved from the electronic databases. There was a trend towards the higher risk of surgical site infection (OR = 0.66; 95%CI: 0.44-1.00; z = 1.94; P < 0.05), higher risk of incomplete total mesorectal resection (OR = 0.62; 95%CI: 0.43-0.91; z = 2.49; P < 0.01) and prolonged length of hospital stay (SMD, -1.59; 95%CI: -0.86--0.25; z = 4.22; P < 0.00001) following OTME. However, the oncological outcomes like number of harvested lymph nodes, tumour recurrence and risk of positive resection margins were statistically similar in both groups. In addition, the clinical outcomes such as operative complications, anastomotic leak and all-cause mortality were comparable between both approaches of mesorectal excision.CONCLUSION: LTME appears to have clinically and oncologically measurable advantages over OTME in patients with primary rectal cancer in both short term and long term follow ups.

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Laparoscopic total mesorectal excision

Cited by 69 publications

References 44 publications

Feasibility of laparoscopic abdomino - perineal resection for large - sized anorectal cancers : A single - institution experience of 59 cases

Feasibility of laparoscopic abdomino - perineal resection for large - sized anorectal cancers : A single - institution experience of 59 cases

Is laparoscopic rectal surgery really not non-inferior?

Systematic review of oncological outcomes following laparoscopicvsopen total mesorectal excision

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