Quality of mesorectum after laparoscopic resection for rectal cancer ‐ Results of an audited teaching programme in Spain

Biondo, Sebastiano; Ortiz, Héctor; Luján, Juan; Codina‐Cazador, A.; Espín, Eloy; García‐Granero, Eduardo; Kreisler, Esther; Miguel, Mario; Alós, Rafael; Echeverria, Andres

doi:10.1111/j.1463-1318.2008.01720.x

Cited by 43 publications

(25 citation statements)

References 40 publications

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“…The five studies reporting over 70 % mesorectal plane of resection are all published after 2006. These studies are either performed in tertiary centers or specialized units [15•, 19, 23, 24•] or report results of an audited teaching program [22]. …”

Section: Incidencementioning

confidence: 99%

“…From the eight mentioned studies, six report mesorectal plane of resection in over 70 % of cases [12, 15•, 22, 23, 24•, 30]. …”

Section: Laparoscopic Tmementioning

confidence: 99%

“…These studies are performed by experienced laparoscopy surgeons from specialized units, and include four single-center trials [12, 15•, 23, 30], one RCT [24•], and one multicenter observational study [22]. …”

Section: Laparoscopic Tmementioning

confidence: 99%

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The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

Bosch

Nagtegaal

2012

Curr Colorectal Cancer Rep

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Total mesorectal excision (TME) is considered standard of care for rectal cancer treatment. Failure to remove the mesorectal fat envelope entirely may explain part of observed local and distant recurrences. Several studies suggest quality of the mesorectum after TME surgery as determined by pathological evaluation may influence prognosis. We aimed to determine the prognostic value of the plane of surgery as well as factors influencing the likelihood of a high-quality specimen by reviewing the literature. A pooled meta-analysis of relevant outcome data was performed where appropriate. A muscularis propria resection plane was found to increase the risk of local recurrence (RR 2.72 [95 % CI 1.36 to 5.44]) and overall recurrence (RR 2.00 [95 % CI 1.17 to 3.42]) compared to an (intra)mesorectal plane. Plane of surgery is an important factor in rectal cancer treatment and the documentation by pathologists is essential for the improvement of TME quality and patient outcome.

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Section: Incidencementioning

confidence: 99%

“…From the eight mentioned studies, six report mesorectal plane of resection in over 70 % of cases [12, 15•, 22, 23, 24•, 30]. …”

Section: Laparoscopic Tmementioning

confidence: 99%

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The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

Bosch

Nagtegaal

2012

Curr Colorectal Cancer Rep

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“…This study did not show differences in the number of lymph nodes retrieved, status of the CRM or in the quality of the mesorectum (complete 77%, nearly complete 15%, incomplete 8%). However, the shortcomings of this study are diverse: it is a voluntary registry, not randomised and obviously selected, with more difficult cases included in the open group [122]. In a recent single-center prospective randomised trial Lujan et al could not find any differences in the quality of the mesorectum or in the rates of local recurrence [88].…”

Section: 7% [Consensus]; Gor A: 857% [Consensus])mentioning

confidence: 89%

Laparoscopic extraperitoneal rectal cancer surgery: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

et al. 2011

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Background The laparoscopic approach is increasingly applied in colorectal surgery. Although laparoscopic surgery in colon cancer has been proved to be safe and feasible with equivalent long-term oncological outcome compared to open surgery, safety and long-term oncological outcome of laparoscopic surgery for rectal cancer remain controversial. Laparoscopic rectal cancer surgery might be efficacious, but indications and limitations are not clearly defined. Therefore, the European Association for Endoscopic Surgery (EAES) has developed this clinical practice guideline. Methods An international expert panel was invited to appraise the current literature and to develop evidence-based recommendations. The expert panel constituted for a consensus development conference in May 2010. Thereafter, the recommendations were presented at the annual congress of the EAES in Geneva in June 2010 in a plenary session. A second consensus process (Delphi process) of the recommendations with the explanatory text was necessary due to the changes after the consensus conference. Results Laparoscopic surgery for extraperitoneal (midand low-) rectal cancer is feasible and widely accepted. The laparoscopic approach must offer the same quality of surgical specimen as in open surgery. Short-term outcomes such as bowel function, surgical-site infections, pain and hospital stay are slightly improved with the laparoscopic approach. Laparoscopic resection of rectal cancer is not

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“…In zwei prospektiven randomisierten Studien waren die Zahlen vergleichbar: In einer spanischen Studie [18] war die Rate 2,9 % (offen) gegen 4 % (laparoskopisch) und in einer Studie aus Hongkong [19] 1,4 % gegen 2,6 %. Ähnlich günsti-ge onkologische Ergebnisse fanden sich auch in einer aktuellen prospektiven Beobachtungsstudie [20]. Allerdings setzen diese Ergebnisse eine große Erfahrung voraus.…”

Section: Originalarbeit 187unclassified

Stand laparoskopischer Operationstechniken

Feussner¹,

Wilhelm²

2011

Endo heute

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Quality of mesorectum after laparoscopic resection for rectal cancer ‐ Results of an audited teaching programme in Spain

Abstract: Laparoscopic resection for rectal cancer is feasible with the quality of mesorectal excision and postoperative outcomes similar to those of open surgery.

Cited by 43 publications

References 40 publications

The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

The Importance of the Pathologist’s Role in Assessment of the Quality of the Mesorectum

Laparoscopic extraperitoneal rectal cancer surgery: the clinical practice guidelines of the European Association for Endoscopic Surgery (EAES)

Stand laparoskopischer Operationstechniken

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