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Laparoscopic surgery for rectal cancer: short-term benefits and oncologic outcomes using more than one technique

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Abstract

Background

Several minimally invasive techniques have now been described for rectal cancer resection. Current outcome data for these approaches from high volume, single institutions remain limited. Our aim was to review outcomes in patients undergoing minimally invasive surgery for rectal cancer at our institution in the current era.

Methods

A retrospective analysis was done to assess short-term benefits and oncologic outcomes in patients undergoing minimally invasive surgery for rectal cancer between 2004 and 2007.

Results

One-hundred consecutive patients (61 men, median age 62) with a median follow-up of 1.8 years were identified. Sixty-seven had hand-assisted laparoscopic surgery (HALS), while 33 were done laparoscopic-assisted (LA). Seventy-two patients underwent anterior resection, 27 an abdominal perineal resection, and 1 a total proctocolectomy. Tumor stage was stage 1 (21%), stage 2 (17%), stage 3 (56%), and stage 4 (6%). A median of 16 lymph nodes, a median 3.4 cm distal margin, and a 99% negative circumferential margin was achieved. The 3-year disease-free and overall survivals were 86.2 and 94.5%, respectively. Three cases required conversion. Median time to both diet and first bowel movement was 3 days, and median length of stay was 5 days. Length of stay, time to soft diet, incision length, and pain scores were less using a LA approach compared to HALS (P < 0.01). Overall morbidity was 26% with no mortality.

Conclusion

Both minimally invasive techniques used achieved excellent oncologic results in patients with rectal cancer. The LA approach had slightly better short-term outcomes.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic Rochester, Mayo Clinic College of Medicine, Rochester, MN, USA

    D. W. Larson, R. R. Cima, J. H. Pemberton & E. J. Dozois

  2. Division of Gastroenterologic and General Surgery, Mayo Clinic Rochester, Rochester, MN, USA

    S. Y. Boostrom

  3. Division of Biostatistics Mayo Clinic Rochester, Mayo Clinic College of Medicine, Rochester, MN, USA

    D. R. Larson

  4. Division of Colorectal surgery, Department of Surgery, Mayo Clinic Rochester, 200 First Street SW, Rochester, MN, 55905, USA

    D. W. Larson

Authors
  1. D. W. Larson
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  2. S. Y. Boostrom
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  3. R. R. Cima
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  4. J. H. Pemberton
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  5. D. R. Larson
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  6. E. J. Dozois
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Correspondence to D. W. Larson.

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Larson, D.W., Boostrom, S.Y., Cima, R.R. et al. Laparoscopic surgery for rectal cancer: short-term benefits and oncologic outcomes using more than one technique. Tech Coloproctol 14, 125–131 (2010). https://doi.org/10.1007/s10151-010-0577-0

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  • DOI: https://doi.org/10.1007/s10151-010-0577-0

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