Robotic lateral pelvic lymph node dissection after chemoradiation for rectal cancer: a Western perspective
| Autor: | Brian K. Bednarski, Harmeet Kaur, Bruce D. Minsky, Y. N. You, George J. Chang, Emma B. Holliday, Melissa W. Taggart, Thitithep Limvorapitak, Oliver Peacock, Arvind Dasari |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Colorectal cancer 030230 surgery 03 medical and health sciences 0302 clinical medicine Blood loss Robotic Surgical Procedures medicine Humans Lymph node Retrospective Studies business.industry Rectal Neoplasms Mortality rate Gastroenterology Perioperative Middle Aged medicine.disease Neoadjuvant Therapy Surgery Dissection medicine.anatomical_structure Treatment Outcome Lymph Node Excision 030211 gastroenterology & hepatology Median body Female Laparoscopy Lymph Nodes Neoplasm Recurrence Local business Neoadjuvant chemoradiotherapy |
| Zdroj: | Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and IrelandReferences. 22(12) |
| ISSN: | 1463-1318 |
| Popis: | Aim There are limited outcome data for lateral pelvic lymph node dissection (LPLND) following neoadjuvant chemoradiotherapy (nCRT), particularly in the West. Our aim was to evaluate the short-term perioperative and oncological outcomes of robotic LPLND at a single cancer centre. Method A retrospective analysis of a prospective database of consecutive patients undergoing robotic LPLND for rectal cancer between November 2012 and February 2020 was performed. The main outcomes were short-term perioperative and oncological outcomes. Major morbidity was defined as Clavien-Dindo grade 3 or above. Results Forty patients underwent robotic LPLND during the study period. The mean age was 54 years (SD ± 15 years) and 13 (31.0%) were female. The median body mass index was 28.6 kg/m2 (IQR 25.5-32.6 kg/m2 ). Neoadjuvant CRT was performed in all patients. Resection of the primary rectal cancer and concurrent LPLND occurred in 36 (90.0%) patients, whilst the remaining 4 (10.0%) patients had subsequent LPLND after prior rectal resection. The median operating time was 420 min (IQR 313-540 min), estimated blood loss was 150 ml (IQR 55-200 ml) and length of hospital stay was 4 days (IQR 3-6 days). The major morbidity rate was 10.0% (n = 4). The median lymph node harvest from the LPLND was 6 (IQR 3-9) and 13 (32.5%) patients had one or more positive LPLNs. The median follow-up was 16 months (IQR 5-33 months), with 1 (2.5%) local central recurrence and 7 (17.5%) patients developing distant disease, resulting in 3 (7.5%) deaths. Conclusion Robotic LPLND for rectal cancer can be performed in Western patients to completely resect extra-mesorectal LPLNs and is associated with acceptable perioperative morbidity. |
| Databáze: | OpenAIRE |
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