Mid- and low-rectal cancer: laparoscopic vs open treatment—short- and long-term results. Meta-analysis of randomized controlled trials

Schietroma, M; Romano, Lucia; Apostol, Adriana Ionelia; Vada, Silvia; Necozione, Stefano; Carlei, F; Giuliani, Antonio

doi:10.1007/s00384-021-04048-9

Cited by 16 publications

(4 citation statements)

References 70 publications

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“…Generally, if the tumor did not invade adjacent organs or vessels, heavy blood loss was rare in both LHP and APR [ 26 , 27 ]. Besides, most surgeries were performed with a laparoscopic approach, and it could further help reduce the blood loss [ 28 ]. The median blood loss was 100 ml in both groups, significantly less than in some previous studies [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Low Hartmann’s procedure versus abdominoperineal resection for rectal cancer, a propensity score matching cohort study

Zhang,

Liu,

Liu

et al. 2024

BMC Gastroenterol

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Background This study aimed to compare low Hartmann’s procedure (LHP) with abdominoperineal resection (APR) for rectal cancer (RC) regarding postoperative complications. Method RC patients receiving radical LHP or APR from 2015 to 2019 in our center were retrospectively enrolled. Patients’ demographic and surgical information was collected and analyzed. Propensity score matching (PSM) was used to balance the baseline information. The primary outcome was the incidence of major complications. All the statistical analysis was performed by SPSS 22.0 and R. Results 342 individuals were primarily included and 134 remained after PSM with a 1:2 ratio (50 in LHP and 84 in APR). Patients in the LHP group were associated with higher tumor height (P < 0.001). No significant difference was observed between the two groups for the incidence of major complications (6.0% vs. 1.2%, P = 0.290), and severe pelvic abscess (2% vs. 0%, P = 0.373). However, the occurrence rate of minor complications was significantly higher in the LHP group (52% vs. 21.4%, P < 0.001), and the difference mainly lay in abdominal wound infection (10% vs. 0%, P = 0.006) and bowel obstruction (16% vs. 4.8%, P = 0.028). LHP was not the independent risk factor of pelvic abscess in the multivariate analysis. Conclusion Our data demonstrated a comparable incidence of major complications between LHP and APR. LHP was still a reliable alternative in selected RC patients when primary anastomosis was not recommended.

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Section: Discussionmentioning

confidence: 99%

Low Hartmann’s procedure versus abdominoperineal resection for rectal cancer, a propensity score matching cohort study

Zhang,

Liu,

Liu

et al. 2024

BMC Gastroenterol

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“…The inclusion criteria were as follows: patient age ranging from 38 to 76; BMI of 26.2 ± 2.4; rectal adenocarcinoma confirmed by preoperative colonoscopy and pathology, defined as low rectal cancer with the lower edge of the tumor less than 5 cm from the dentate line ( 3 ); clinical tumor stage T1-T3 (according to the American Joint Committee on Cancer (AJCC) 7th edition TNM tumor staging criteria); no lymph node metastasis; diameter <6 cm; good cardiopulmonary function; and no distant metastasis. See Table 1 for details.…”

Section: Methodsmentioning

confidence: 99%

A prospective study of specimen eversion to lateral rectum and valgus resection for low rectal cancer

Qian

Huang

et al. 2022

Front. Surg.

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PurposeTo investigate the safety and efficacy of a reverse puncture device (RPD) and specimen eversion of the rectum for resection in total laparoscopic proctectomy.MethodsIn a prospective study from August 2019 to March 2021, 40 patients underwent a procedure with an RPD and specimen eversion of the rectum for total laparoscopic low rectal cancer resection, that is natural orifice specimen extraction surgery (NOSES), were included in the NOSES group. Forty patients in the control group underwent conventional laparoscopic radical resection for low rectal cancer and were included in the LAP group. Intraoperative- and postoperative-related indicators, recovery and inflammatory factors, quality of life (QOL) and mental health were compared.ResultsAll operations were successfully completed. Compared with the LAP group, the NOSES group showed better short-term outcomes, such as time to eating, postoperative pain, and especially postoperative incision-related complications. At the same time, postoperative inflammatory factor levels, psychological trauma, life-related anxiety and depression scores, and QOL were better in the NOSES group than in the LAP group.ConclusionsThe application of an RPD and specimen eversion of the rectum for total laparoscopic low rectal cancer resection is a technically feasible and safe approach with a short-term curative effect.

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“…Nevertheless, many prospective studies have confirmed the safe and effective use of laparoscopy in the treatment of locally advanced low rectal carcinoma. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

Laparoscopic extralevator abdominoperineal resection for low rectal cancer: The myth of reinventing the wheel

Bakhtiar,

Nasir,

Dr. Muhammad Fahd Shah

et al. 2023

Pak J Med Sci

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Background & Objective: To review oncological outcomes of laparoscopic extralevator abdominoperineal excision (LAP-ELAPE) for low rectal cancer.In locally advanced low rectal cancer, ELAPE which is en-bloc resection of levator muscles along with the tumor in a prone position has significantly decreased the rate of having either positive circumferential resection margin (CRM) or tumor perforation. The aim of the study was to determine the oncological outcomes of laparoscopic extralevator abdominoperineal excision (LAP-ELAPE) for low rectal cancer. Methods: This retrospective study was performed at Shaukat Khanum Cancer Hospital and Research Centre Lahore. Patients who underwent ELAPE for low rectal and anal cancer from January 2014 to December 2019 were selected. Data was collected using an electronic database through a hospital information system. Results: A total of 82 patients were included in the study having a median age of 39 years. Clinically preoperative tumor sizes were T2:2, T3:65, T4:15. Neo-adjuvant chemo radiotherapy was administered to 79 (96.3%) patients. Pathologically tumor sizes were T0:12, T2:15, T3:50, T4:5 with 79.2% (n=65) R0 resections. The mean operative time was 340.36±64.51 minutes and the mean blood loss was 99 milliliters. The mean postoperative hospital stay was 6.58±4.64 days. Seventeen (20.7%) cases had pathological circumferential resection margins positive (pCRM<1mm). However, tumor perforation was found in 8(9.8%) patients. Ninety days mortality was none while 36 patients experienced recurrence (local: 23, distant: 30, local + distant 17). The median survival time was 53.00±2.69 months. Conclusion: For locally advanced low rectal cancer, ELAPE has evolved as a safe oncological procedure with acceptable outcomes. doi: https://doi.org/10.12669/pjms.40.1.7619 How to cite this: Bakhtiar N, Nasir I, Shah MF, Ihtisham-Ulah, Shakeel O, Khattak S, et al. Laparoscopic extralevator abdominoperineal resection for low rectal cancer: The myth of reinventing the wheel. Pak J Med Sci. 2024;40(1):---------. doi: https://doi.org/10.12669/pjms.40.1.7619 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Mid- and low-rectal cancer: laparoscopic vs open treatment—short- and long-term results. Meta-analysis of randomized controlled trials

Cited by 16 publications

References 70 publications

Low Hartmann’s procedure versus abdominoperineal resection for rectal cancer, a propensity score matching cohort study

Low Hartmann’s procedure versus abdominoperineal resection for rectal cancer, a propensity score matching cohort study

A prospective study of specimen eversion to lateral rectum and valgus resection for low rectal cancer

Laparoscopic extralevator abdominoperineal resection for low rectal cancer: The myth of reinventing the wheel

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