Laparoscopic versus open total mesorectal excision: a case-control study

Breukink, Stéphanie O.; Pierie, J. P. E. N.; Grond, A. J. K.; Hoff, Christiaan; Wiggers, Theo; Meijerink, W. J. H. J.

doi:10.1007/s00384-004-0715-0

Cited by 51 publications

(44 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In contrast to the study by Quah et al [16], which reported worse male sexual outcome in laparoscopically operated patients, recent feasibility and comparative studies, as well as a randomized series between open and laparoscopic TME by Leung et al [17], have shown short-term benefits to rectal cancer of the laparoscopic approach over the open approach, without compromising oncological outcome [17,18,19,20,21,22]. These studies reported mean operative times between 178 and 250 min with conversion rates between 10 and 23%.…”

Section: Discussionmentioning

confidence: 54%

Laparoscopic versus Open Total Mesorectal Excision: A Comparative Study on Short-Term Outcomes

Veenhof

Engel

Craanen³

et al. 2007

Dig Surg

View full text Add to dashboard Cite

Background: Laparoscopic total mesorectal excision (TME) is being used in rectal cancer more frequently. The aim of this study was to analyze the differences in short-term outcomes between open and laparoscopic TME. Methods: In this nonrandomized consecutive study, the short-term outcomes of 100 patients undergoing TME for proven rectal cancer were analyzed. Results: Two groups of 50 patients underwent an open or laparoscopic TME for rectal cancer. Both groups were comparable. Laparoscopic surgery took longer to perform (250 vs. 197.5 min, p < 0.01), but was accompanied by less blood loss (350 vs. 800 ml, p < 0.01). Enteric function recovered sooner after laparoscopy. The numbers of major and minor complications were comparable between both groups, although fewer patients had major complications in the laparoscopic group (6 vs. 15 patients, p = 0.03). Hospital stay was shorter for patients who underwent a laparoscopic abdominoperineal resection (10 vs. 12 days, p = 0.04). Median follow-up was 17 months for the laparoscopic group and 22 months for the open group. Survival analyses between the groups showed no statistical difference in disease-free and overall survival. Conclusion: This study shows that laparoscopic TME for rectal cancer is a safe and feasible technique with some short-term benefits over open TME.

show abstract

Section: Discussionmentioning

confidence: 54%

Laparoscopic versus Open Total Mesorectal Excision: A Comparative Study on Short-Term Outcomes

Veenhof

Engel

Craanen³

et al. 2007

Dig Surg

View full text Add to dashboard Cite

show abstract

“…less postoperative pain, less narcotic use and shorter hospital stay [3][4][5]. Furthermore, the magnification effect of laparoscopy enhances the exposure of the pelvic cavity.…”

mentioning

confidence: 99%

Male sexual function and lower urinary tract symptoms after laparoscopic total mesorectal excision

Breukink

Driel

Pierie

et al. 2008

Int J Colorectal Dis

Self Cite

View full text Add to dashboard Cite

Background and aims The aim of this study was to investigate sexual function and the presence of lower urinary tract symptoms (LUTS) in male patients with rectal cancer following short-term radiotherapy and laparoscopic total mesorectal excision (LTME) by physical and psychological measurements. Materials and methods Sexual function and LUTS were assessed by the use of questionnaires [International Index of Erectile Function (IIEF), International Prostate Symptom Score]. Sexual function was further assessed by the use of pharmaco duplex ultrasonography of the cavernous arterial blood flow and nocturnal penile tumescence and rigidity monitoring (NPTR). All investigations were performed prior to the start of preoperative radiotherapy and 15 months after surgery. Results Nine patients (mean age 60 years) participated. Erectile function was maintained in 71% and ejaculation function in 89%. Compared with pre-operative scores on the IIEF, a significant deterioration in intercourse satisfaction was seen following radiotherapy and LTME (7.9 vs 10.3, p=0.042), but overall satisfaction remained unchanged (8.0 vs 7.0, p=0.246). NPTR parameters (duration of erectile episodes, duration of tip rigidity ≥60%) decreased following radiotherapy and LTME. Patients reported a deterioration in micturition frequency (2.0 vs 1.0, p=0.034) and quality of life due to urinary symptoms (8.0 vs 1.8, p=0.018). Conclusion Based on these first preliminary findings, data suggest that 15 months after short-term radiotherapy and LTME in men with rectal cancer, objectively assessed sexual dysfunction was considerable, but overall sexual satisfaction had not changed.

show abstract

“…However, these advantages of LTME can only be availed optimally by colorectal surgeons when its oncological viability is proven on scientific grounds. One would assume that LTME for rectal cancer should offer survival and recurrence similar to OTME [17][18][19] . In addition, several studies have also reported the concerns towards LTME requiring longer duration of operation, needing extensive learning curve for colorectal surgeons, particularly junior colorectal trainees and cost implications of the procedure [20,21] .…”

Section: Introductionmentioning

confidence: 99%

Systematic review of oncological outcomes following laparoscopicvsopen total mesorectal excision

Sajid

Ahamd

Miles

et al. 2014

WJGE

View full text Add to dashboard Cite

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.

show abstract

Laparoscopic versus open total mesorectal excision: a case-control study

Abstract: This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique compared with open surgery.

Cited by 51 publications

References 29 publications

Laparoscopic versus Open Total Mesorectal Excision: A Comparative Study on Short-Term Outcomes

Laparoscopic versus Open Total Mesorectal Excision: A Comparative Study on Short-Term Outcomes

Male sexual function and lower urinary tract symptoms after laparoscopic total mesorectal excision

Systematic review of oncological outcomes following laparoscopicvsopen total mesorectal excision

Contact Info

Product

Resources

About