Standardization of Laparoscopic Total Mesorectal Excision for Rectal Cancer

Mišković, Danilo; Foster, Jake; Agha, Ayman; Delaney, Conor P.; Francis, Nader; Hasegawa, Hirotoshi; Карачун, А. М.; Kim, Seon H ahn; Law, Wai Lun; Marks, John; Morino, Mario; Panís, Yves; Uriburu, Juan C arlos Patrón; Wexner, Steven D.; Parvaiz, Amjad

doi:10.1097/sla.0000000000000823

Cited by 79 publications

(57 citation statements)

References 19 publications

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“…Medial to lateral colonic mobilisation with isolation of the main vessels using clips was applied followed by TME using monopolar diathermy [20, 21]. …”

Section: Methodsmentioning

confidence: 99%

Robotic rectal cancer surgery in obese patients may lead to better short-term outcomes when compared to laparoscopy: a comparative propensity scored match study

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Abbas

et al. 2018

Int J Colorectal Dis

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PurposeLaparoscopic rectal surgery in obese patients is technically challenging. The technological advantages of robotic instruments can help overcome some of those challenges, but whether this translates to superior short-term outcomes is largely unknown. The aim of this study is to compare the short-term surgical outcomes of obese (BMI ≥ 30) robotic and laparoscopic rectal cancer surgery patients.MethodsAll consecutive obese patients receiving laparoscopic and robotic rectal cancer resection surgery from three centres, two from the UK and one from Portugal, between 2006 and 2017 were identified from prospectively collated databases. Robotic surgery patients were propensity score matched with laparoscopic patients for ASA grade, neoadjuvant radiotherapy and pathological T stage. Their short-term outcomes were examined.ResultsA total of 222 patients were identified (63 robotic, 159 laparoscopic). The 63 patients who received robotic surgery were matched with 61 laparoscopic patients. Cohort characteristics were similar between the two groups. In the robotic group, operative time was longer (260 vs 215 min; p = 0.000), but length of stay was shorter (6 vs 8 days; p = 0.014), and thirty-day readmission rate was lower (6.3% vs 19.7%; p = 0.033).ConclusionsIn this study population, robotic rectal surgery in obese patients resulted in a shorter length of stay and lower 30-day readmission rate but longer operative time when compared to laparoscopic surgery. Robotic rectal surgery in the obese may be associated with a quicker post-operative recovery and reduced morbidity profile. Larger-scale multi-centre prospective observational studies are required to validate these results.

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“…Medial to lateral colonic mobilisation with isolation of the main vessels using clips was applied followed by TME using monopolar diathermy [20, 21]. …”

Section: Methodsmentioning

confidence: 99%

Robotic rectal cancer surgery in obese patients may lead to better short-term outcomes when compared to laparoscopy: a comparative propensity scored match study

Panteleimonitis

Pickering

Abbas

et al. 2018

Int J Colorectal Dis

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“…For laparoscopic surgery, the operation was recorded directly from standard laparoscopic theatre equipment using a Medicapture 300 HD analysis to facilitate evaluation of surgery [8]. Interviews with experts together with previous descriptions of OCHRA were used to generate a checklist of potential errors.…”

Section: Outcome Measures Evaluation Of Technical Errorsmentioning

confidence: 99%

Surgical timing after chemoradiotherapy for rectal cancer, analysis of technique (STARRCAT): results of a feasibility multi-centre randomized controlled trial

et al. 2016

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“…This is one of the largest international Delphi consensus studies conducted by expert surgeons to date [21][22][23], with an excellent response rate of >90%. LC is the most widely diffused laparoscopic surgery across the globe and is performed as a daily procedure in community hospitals as well as tertiary centers.…”

Section: Discussionmentioning

confidence: 99%

An opportunity in difficulty: Japan-Korea-Taiwan expert Delphi consensus on surgical difficulty during laparoscopic cholecystectomy

Iwashita

Hibi

Ohyama

et al. 2017

J Hepatobiliary Pancreat Sci

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Background We previously identified 25 intraoperative findings during laparoscopic cholecystectomy (LC) as potential indicators of surgical difficulty per nominal group technique. This study aimed to build a consensus among expert LC surgeons on the impact of each item on surgical difficulty. Methods Surgeons from Japan, Korea, and Taiwan (n = 554) participated in a Delphi process and graded the 25 items on a seven-stage scale (range, 0-6). Consensus was defined as (1) the interquartile range (IQR) of overall responses ≤2 and (2) ≥66% of the responses concentrated within a median AE 1 after stratification by workplace and LC experience level. Results Response rates for the first and the second-round Delphi were 92.6% and 90.3%, respectively. Final consensus was reached for all the 25 items. 'Diffuse scarring in the Calot's triangle area' in the 'Factors related to inflammation of the gallbladder' category had the strongest impact on surgical difficulty (median, 5; IQR, 1). Surgeons agreed that the surgical difficulty increases as more fibrotic change and scarring develop. The median point for each item was set as the difficulty score. Conclusions A Delphi consensus was reached among expert LC surgeons on the impact of intraoperative findings on surgical difficulty.

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Standardization of Laparoscopic Total Mesorectal Excision for Rectal Cancer

Abstract: Objective: To establish a structured international expert consensus on a detailed technical description of the laparoscopic total mesorectal excision (TME).Background: Laparoscopic TME is a common surgical approach for the treatment of rectal

Cited by 79 publications

References 19 publications

Robotic rectal cancer surgery in obese patients may lead to better short-term outcomes when compared to laparoscopy: a comparative propensity scored match study

Robotic rectal cancer surgery in obese patients may lead to better short-term outcomes when compared to laparoscopy: a comparative propensity scored match study

Surgical timing after chemoradiotherapy for rectal cancer, analysis of technique (STARRCAT): results of a feasibility multi-centre randomized controlled trial

An opportunity in difficulty: Japan-Korea-Taiwan expert Delphi consensus on surgical difficulty during laparoscopic cholecystectomy

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