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Short- and midterm outcomes of laparoscopic surgery compared for 131 patients with rectal and rectosigmoid cancer

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Abstract

Background

This study aimed to clarify and compare the short- and midterm surgical outcomes of laparoscopic surgery for rectal and rectosigmoid cancer.

Methods

Between June 1992 and December 2004, 131 selected patients with cancer of the rectum (n = 60) and rectosigmoid (n = 71) underwent laparoscopic surgery. The indications for laparoscopy included a preoperative diagnosis of T1/T2 tumor in the rectum and T1–T3 tumors in the rectosigmoid.

Results

The mean follow-up period was 42 months. The procedures included anterior resection for 117 patients, abdominoperineal resection for 11 patients, Hartmann’s procedure for 1 patient, and restorative proctocolectomy for 1 patient. Conversion to an open procedure occurred for four patients (3.1%). Postoperative complications developed in 29 patients (22.1%), including anastomotic leakage in 14 patients (11.8%). The length of hospital stay for the rectal cases was significantly longer than for the rectosigmoid cases (10 vs 7 days; p = 0.0049). The tumor node metastasis (TNM) stages included 0 (n = 14), I (n = 72), II (n = 15), III (n = 29), and IV (n = 1). Recurrences were experienced by 13 patients, including local recurrence (n = 7) and recurrences involving the liver ((n = 2), lung (n = 3), and distant lymph nodes (n = 1). The 5-year disease-free and overall survival rates were, respectively 91.7% and 97.9% for stage I, 86.7% and 90.9% for stage II, and 77.1% and 90.0% for stage III.

Conclusions

Laparoscopic surgery is feasible and safe for selected patients with rectal or rectosigmoid cancer. The selected patients in this study experienced favorable short- and midterm outcomes.

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Acknowledgment

The authors are indebted to Prof. J Patrick Barron of the International Medical Communications Centre of Tokyo Medical University for his review of this report.

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Authors and Affiliations

  1. Department of Surgery, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    H. Hasegawa, Y. Ishii, H. Nishibori, T. Endo & M. Kitajima

  2. Department of Surgery, Kitasato University, Kanagawa, Japan

    M. Watanabe

Authors
  1. H. Hasegawa
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  2. Y. Ishii
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  3. H. Nishibori
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  4. T. Endo
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  5. M. Watanabe
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  6. M. Kitajima
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Corresponding author

Correspondence to H. Hasegawa.

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Hasegawa, H., Ishii, Y., Nishibori, H. et al. Short- and midterm outcomes of laparoscopic surgery compared for 131 patients with rectal and rectosigmoid cancer. Surg Endosc 21, 920–924 (2007). https://doi.org/10.1007/s00464-006-9132-5

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  • DOI: https://doi.org/10.1007/s00464-006-9132-5

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