Laparoscopic resection for rectal cancer: a prospective analysis of thirty-month follow-up outcomes in 312 patients

  • Seon-Hahn Kim
  • In-Ja Park
  • Yong-Geul Joh
  • Koo-Yong Hahn
Article

Abstract

Background

This study aimed to prospectively evaluate operative safety and mid-term oncologic outcomes of laparoscopic rectal cancer resection performed by a single surgeon.

Methods

Three hundreds twelve patients (male, 181) were enrolled in this analysis. 257 patients (82.4%) had tumors located below 12 cm from the anal verge. Distribution of TNM stages was 0:I:II:III:IV = 4.2%:17.9%:32.4%:37.2%:8.3%. 225 patients (71.1%) had T3/T4 lesions. Pre- and post-operative radiation was given in 6 and 20 patients, respectively.

Results

Sphincter-preserving operation was performed in 85.9%. Mean operating time was 212 minutes. Conversion rate was 2.6%. Overall morbidity rate was 21.1%. Anastomotic leakage occurred in 6.4%. Operative mortality rate was 0.3%. Mean number of harvested nodes was 23. Mean distal tumor-free margin was 2.8 cm. The circumferential resection margin was positive in 13 patients (4.2%). With a mean follow-up of 30 months in the stage I–III patients, the local recurrence rate was 2.9%. Systemic recurrence occurred in 11.7%. No port-site recurrence was observed.

Conclusion

Laparoscopic resection of rectal cancer provided safe operative parameters and adequate mid-term oncologic outcomes. When considering a high volume of advanced and low-lying cancers but rather narrow indication to radiotherapy, the 2.9% local recurrence rate seems promising data. Long-term follow-up is mandatory to draw conclusion.

Keywords

Rectal cancer Laparoscopic resection Mid-term outcome Prospective 

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Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Seon-Hahn Kim
    • 1
  • In-Ja Park
    • 1
  • Yong-Geul Joh
    • 2
  • Koo-Yong Hahn
    • 2
  1. 1.Colorectal Division, Department of SurgeryDigestive Disease Center, DongGuk University HospitalGoyang 
  2. 2.Laparoscopic Colon Surgery Unit, Department of SurgeryHansol HospitalSeoulKorea

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