Results of a multicenter study of 1,057 cases of rectal cancer treated by laparoscopic surgery
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The aim of this study was to clarify the feasibility of laparoscopic surgery for rectal cancer retrospectively in 28 centers throughout Japan.
Between May 1994 and February 2006, 1,057 selected patients with rectal cancer underwent laparoscopic surgery. All the data regarding the patient details, and operative and postoperative outcome were collected retrospectively.
Mean follow-up was 30 months. Procedures included anterior resection in 938, abdominoperineal resection in 107, Hartmann’s procedure in 10, and others in two patients. Conversion to open procedures occurred in 77 patients (7.3%). Postoperative surgical complications developed in 235 patients (22.2%), including anastomotic leakage in 84 (9.1%). Median length of postoperative hospital stay was 15 days (7–271 days). Patients with upper rectal cancer had shorter hospital stay than those with lower rectal cancer (14 versus 18 days, p < 0.01). Tumor–node–metastases (TNM) stage included 83(7.9%) stage 0, 495 (46.8%) stage I, 197 (18.6%) stage II, 230 (21.8%) stage III, and 52 (4.9%) stage IV. Recurrence was developed in 67 patients (6.6%) of the 1,011 curatively treated patients. Local recurrence occurred in 11 patients (1.0%). There was no port-site metastasis. Of the 1,011 curatively treated patients, the 3-year disease-free survival rate was 100% in stage 0, 94.6% in stage I, 82.1% in stage II, and 79.7% in stage III.
Laparoscopic surgery is feasible and safe in selected patients with rectal cancer, with favorable short-term and mid-term outcome.
KeywordsRectal cancer Laparoscopic surgery Short-term outcome Multicenter study
This study was supported in part by Japanese Society for Cancer of the Colon and Rectum. The following surgeons and institutions participated in this multicenter study initiated by the Japan Society of Laparoscopic Colorectal Surgery: Masahiko Watanabe, Yukihito Kokuba, Kitasato University (Sagamihara); Fumio Konishi, Yutaka Kawamura, Omiya Medical Center Jichi Medical School (Omiya); Nobuyoshi Miyajima, Teikyo University Hospital Mizonokuchi (Kawasaki); Masaki Fukunaga, Juntendo Urayasu Hospital Juntendo University School of Medicine (Urayasu); Shinei Kudo, Junichi Tanaka, Northern Yokohama Hospital Showa University (Yokohama); Nobuhiko Tanigawa, Junji Okuda, Osaka Medical University (Osaka); Hideo Nagai, Hisanaga Horie Jichi Medical School (Tochigi); Koki Otsuka, Iwate Medical University (Sendai); Yosuke Fukunaga, Osaka City Genaral Hospital (Osaka); Masazumi Okajima, Hiroshima University Graduate School of Biomedical Sciences (Hiroshima); Hiroyuki Bandou, Ishikawa Prefectural Central Hospital (Kanazawa); Seigo Kitano, Masafumi Inomata, Oita University Faculty of Medicine, Yoshiro Kubo, Shikoku Cancer Center (Matsuyama); Takao Ichihara, Nishinomiya Municipal Central Hospital (Nishinomiya); Hirotoshi Hasegawa, Keio University School of Medicine (Tokyo); Seiichiro Yamamoto, National Cancer Center (Tokyo); Shigeru Ikoma, Ikoma Hospital (Kagoshima); Yasuhiko Nishiyama, National Hospital Organization Sagamihara National Hospital (Sagamihara); Kenichi Sugihara, Masayuki Enomoto, Tokyo Medical and Dental University Graduate School (Tokyo); Shigeki Yamaguchi, Shizuoka Cancer Center (Shizuoka); Mitsugu Sekimoto, Osaka University Graduate School of Medicine, Masahiko Masaki, Kyorin University (Tokyo); Hitoshi Idani, Fukuyama City Hospital (Fukuyama); Yoshinobu Sumiyama, Yoshihisa Saida, Ohashi Hospital Toho University School of Medicine (Tokyo); Yoshinori Munemoto, Fukui Saiseikai Hospital (Fukui); Kotaro Maeda, Koichi Hanai, Fujita Health University (Toyoake); Hiroya Kuroyanagi, The Cancer Institute Hospital of JFCR (Tokyo); Kazuki Ueda, Kinki University (Osaka).
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