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Laparoscopic versus open total mesorectal excision: a case-control study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background and aims

Because definitive long-term results are not yet available, the oncological safety of laparoscopic surgery for treatment of rectal cancer remains unproven. The aim of this prospective non-randomised study was to assess the feasibility and short-term outcome of laparoscopic total mesorectal excision (LTME) after 25–30 Gy preoperative radiotherapy and to compare the results with a matched-control group of open TME (OTME).

Materials and methods

A series of 41 patients with primary rectal cancer underwent LTME for rectal cancer and were matched with a historical control group of 41 patients who underwent OTME. Both groups received preoperative short-term radiotherapy.

Results

There was no mortality in the LTME group and 2% mortality in the OTME group. The overall postoperative morbidity was 37% in the LTME group and 51% in the OTME group, including an anastomotic leakage of 9 and 14% in the LTME and OTME groups respectively. A positive circumferential margin was found in 7% of patients in the LTME group and in 12% of the patients in the OTME group.

Conclusion

This study shows that LTME is technically feasible and can be performed safely. We show at least a similar surgical completeness using a laparoscopic technique compared with open surgery.

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Authors and Affiliations

  1. Department of Surgery, Groningen University Hospital, Groningen, The Netherlands

    S. O. Breukink & T. Wiggers

  2. Department of Surgery, Medical Center Leeuwarden, Leeuwarden, The Netherlands

    J. P. E. N. Pierie, C. Hoff & W. J. H. J. Meijerink

  3. Department of Pathology, Laboratory of Public Health, Leeuwarden, The Netherlands

    A. J. K. Grond

  4. Noorderhaven 35, 9712 VH, Groningen, The Netherlands

    S. O. Breukink

Authors
  1. S. O. Breukink
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  2. J. P. E. N. Pierie
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  3. A. J. K. Grond
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  4. C. Hoff
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  5. T. Wiggers
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  6. W. J. H. J. Meijerink
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Correspondence to S. O. Breukink.

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Breukink, S.O., Pierie, J.P.E.N., Grond, A.J.K. et al. Laparoscopic versus open total mesorectal excision: a case-control study. Int J Colorectal Dis 20, 428–433 (2005). https://doi.org/10.1007/s00384-004-0715-0

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  • DOI: https://doi.org/10.1007/s00384-004-0715-0

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