Technical feasibility of laparoscopic total mesorectal excision for patients with low rectal cancer after concurrent radiation and chemotherapy with bevacizumab plus FOLFOX

Abstract

Based on the controllable surgical complications and minimal invasiveness in the current patient series, laparoscopic TME is shown to be technically feasible and can be recommended for patients with advanced lower rectal cancer requiring preoperative CCRT using bevacizumab as the additional therapeutic agent.

Additional chemotherapy with 5-FU plus leucovorin between preoperative chemoradiotherapy and surgery improved treatment outcomes in patients with locally advanced rectal cancer.

“…Several studies with additional chemotherapy have been performed using FOLFOX [16], FOLFOX plus bevacizumab [17], and capecitabine [13]. In a previous study with FOLFOX plus bevacizumab for additional chemotherapy, pCR (25.0%) was higher than the pCR (21.7%) observed in the present study, but the morbidity (21.4%) and mortality (3.6%) rates were higher in the previous study than those in the present study.…”

Laparoscopic Versus Open Surgery for Mid-Low Rectal Cancer: a Systematic Review and Meta-Analysis on Short- and Long-Term Outcomes

“…Papers without rectal cancer LS and OS comparisons were excluded, which left 31 potentially eligible studies. From the overall pool of full-text articles, 18 articles were excluded for the following reasons: they did not offer available outcomes (n=4), [16][17][18][19] the study quality was low (n=3), [20][21][22] and the tumour distance from the anal verge was more than 10 cm (n=11). [23][24][25][26][27][28][29][30][31][32][33] Thirteen articles were published in English for the final metaanalysis.…”

Intra-operative double-stapled colorectal or coloanal anastomotic complications of laparoscopic low anterior resection for rectal cancer: double-stapled anastomotic complication could result in persistent anastomotic leakage

“…Those changes may cause mucosal atrophy, intestinal wall fibrosis and vascular sclerosis; may make stapler application more difficult; and may increase the rate of persistent leakage. To the contrary, several studies reported that preoperative radiation did not affect technical feasibility nor significantly increase surgical morbidities or complications [29,30]. In this study, there is no association between neoadjuvant chemoradiation and intra-operative double-stapled anastomotic complications.…”