Prognostic implications of surgical specimen quality on the oncological outcomes of open and laparoscopic surgery in mid and low rectal cancer
| Autor: | José Martín-Arévalo, Leticia Pérez-Santiago, David Moro-Valdezate, María Lapeña-Rodríguez, V. Pla-Martí, Mireia Bauzá-Collado, Stephanie García-Botello, Marisol Huerta, Susana Roselló-Keränen, Alejandro Espí-Macías |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Laparoscopic surgery
Adult medicine.medical_specialty Survival Colorectal cancer medicine.medical_treatment Surgical oncology Colorectal surgery medicine Humans Laparoscopy Recte Malalties Retrospective Studies medicine.diagnostic_test business.industry Rectal Neoplasms digestive oral and skin physiology Vascular surgery medicine.disease Prognosis Surgery Treatment Outcome Cardiothoracic surgery Original Article Neoplasm Recurrence Local Càncer Cirurgia business human activities Abdominal surgery |
| Zdroj: | Pla Martí, Vicente Martín Arévalo, José Moro Valdezate, David García Botello, Stephanie Anne Pérez Santiago, Leticia Lapeña Rodríguez, María Bauzá Collado, Mireia Huerta, Marisol Roselló Keränen, Susana Espí Macías, Alejandro 2021 Prognostic implications of surgical specimen quality on the oncological outcomes of open and laparoscopic surgery in mid and low rectal cancer Langenbecks Archives of Surgery 406 8 2759 2767 Langenbeck's Archives of Surgery |
| Popis: | Purpose Determine differences in pathologic outcomes between laparoscopic (LAP) and open surgery (OPEN) for mid and low rectal cancer and its influence in long-term oncological outcomes. Methods Retrospective case matched study at a tertiary institution. Adults with rectal cancer below 12 cm from the anal verge operated between January 2005 and September 2018 were included. Primary outcomes were quality of specimen, overall survival (OS), disease-free survival (DFS), and local recurrence (LR). Results The study included 311 patients, LAP = 108 (34.7%), OPEN = 203 (65,3%). A successful resection was accomplished in 81% of the LAP group and in 84.5% of the OPEN (p = 0.505). No differences in free distal margin (LAP = 100%, OPEN = 97.5%; p = 0.156) or circumferential resection margin (LAP = 95.2%, OPEN = 93.2%; p = 0.603) were observed. However, mesorectum quality was incomplete in 16.2% for LAP and in 8.1% for OPEN (p = 0.048). OS was 91.1% for LAP and 81.1% for OPEN (p = 0.360). DFS was 81.4% for LAP and 77.5% for OPEN (p = 0.923). Overall, LR was 2.3% without differences between groups. Conclusions Laparoscopic approach could affect the quality of surgical specimen due to technical aspects. However, if principles of surgical oncology are respected, minor pathologic differences in the quality of the mesorectum may not influence on the long-term oncologic outcomes. |
| Databáze: | OpenAIRE |
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