On the safety of laparoscopic total mesorectal excision for middle and lower rectal cancer
- VernacularTitle:腹腔镜直肠全系膜切除术治疗中、低位直肠癌的临床安全性对比研究
- Author:
Wei FU
;
Jiong YUAN
;
Decheng WANG
- Publication Type:Journal Article
- Keywords:
Laparoscopic total mesorectal excision;
Rectal cancer
- From:
Chinese Journal of Minimally Invasive Surgery
2001;0(06):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the safety of laparoscopic total mesorectal excision for middle and lower rectal cancer.Methods A retrospective comparison was made between 52 cases of open total mesorectal excision from December 2002 to December 2005(Open Group) and 49 cases of laparoscopic mesorectal excision from January 2003 to June 2006(Laparoscopic Group).Results There was no difference in baseline parameters between the two groups.As compared with the Open Group,the Laparoscopic Group presented less blood loss [for anterior resection: 160?106 ml(n=37) vs 298?186 ml(n=36),t=-3.908,P=0.000;for abdominoperineal resection: 180?153 ml(n=10) vs 356?170 ml(n=14),t=-2.604,P=0.016].The recovery time of bowel functions was shorter in the Laparoscopic Group than in the Open Group(2.4?1.8 d vs 3.6?1.5 d;t=-3.648,P=0.000).The overall complication rate in the Laparoscopic Group(14.3%,7/49) was lower than that in the Open Group(44.2%,23/52)(?2=10.834,P=0.001).No significant difference was seen between the two groups in the number of lymph node resected(12.7?6.5 vs 13.6?7.0;t=-0.668,P=0.505),with negative margins in both groups.Follow-up observations were carried out in 45 cases in the Laparoscopic Group(91.8%) for 2～42 months and in 47 cases in the Open Group(90.4%) for 6～42 months,respectively.The local recurrence rate was respectively 4.4% in the Laparoscopic Group(2/45) and 4.3% in the Open Group(2/47). Conclusions Laparoscopic total mesorectal excision for middle and lower rectal cancer is safe and feasible.
