Oncological adequacy of laparoscopic rectal cancer resection: An audit in Indian perspective
Autor: | Prakash Kurumboor, Vipin I Sreekumar, Fadl H Veerankutty, Sidharth Chacko, Deepak Varma, Nandu Nair |
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Jazyk: | angličtina |
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Colorectal cancer laparoscopy lcsh:Surgery Rectum Audit 03 medical and health sciences 0302 clinical medicine Open Resection medicine lcsh:RC799-869 Laparoscopy rectal cancer minimally invasive surgery Mesorectal circumferential resection margin medicine.diagnostic_test business.industry total mesorectal excision fungi Cancer lcsh:RD1-811 colorectal neoplasms medicine.disease Total mesorectal excision Surgery medicine.anatomical_structure 030220 oncology & carcinogenesis Original Article 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology business quality of surgery |
Zdroj: | Journal of Minimal Access Surgery, Vol 16, Iss 3, Pp 251-255 (2020) Journal of Minimal Access Surgery |
ISSN: | 1998-3921 0972-9941 |
Popis: | Background: Laparoscopic resection for rectal cancer (LRR) has gained popularity because of better short-term outcomes and less post-operative morbidity. However, LRR is still not endorsed as a standard of care mainly due to concerns centred on oncological safety in comparison with open approach. Moreover, two recent randomised trials (Australian Laparoscopic Cancer of the Rectum [ALaCaRT] and the American College of Surgeons Oncology Group [ACOSOG] Z6051) have failed to prove that LRR is non-inferior to open resection. Studies on oncological adequacy of LRR in the Indian population in terms of quality of mesorectal excision are scarce. In this article, we aim to audit the oncological adequacy of LRR in our centre and thereby critically analyse the reliability of extrapolation of results of ALaCaRT and ACOSOG trials to the Indian population. Methods: We retrospectively analysed the oncological adequacy of LRR in terms of completeness of total mesorectal excision (TME), distal and circumferential resection margin (CRM) status and nodal harvest in patients with rectal cancer who underwent LRR between January 2016 and June 2018 at our centre. Results: Of 157 patients included in this study, a complete TME was achieved in 148 (94.26%) patients and nearly complete in 7 (4.46%) patients. A safe CRM (≥1 mm) was obtained in 151 (96.18%) patients. Distal margin results were negative in 155 (98.73%) patients. Average nodal harvest was 19.86 ± 9.28. Overall surgical success, calculated as a composite measure of negative distal margin and negative CRM and complete TME was 95.54%. Conclusion: Good quality rectal cancer resection can be achieved by experienced laparoscopic surgeons without compromising oncological safety. |
Databáze: | OpenAIRE |
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