| Autor: |
Ichiro Takemasa, Atsushi Hamabe, Masaaki Ito, Shuichiro Matoba, Jun Watanabe, Suguru Hasegawa, Masanori Kotake, Masafumi Inomata, Kazuki Ueda, Kay Uehara, Kazuhiro Sakamoto, Masataka Ikeda, Tsunekazu Hanai, Tsuyoshi Konishi, Shigeki Yamaguchi, Daisuke Nakano, Shigeru Yamagishi, Kenji Okita, Atsushi Ochiai, Yoshiharu Sakai, Masahiko Watanabe, Japan Society of Laparoscopic Colorectal Surgery |
| Jazyk: |
angličtina |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
Annals of Gastroenterological Surgery, Vol 6, Iss 6, Pp 767-777 (2022) |
| Druh dokumentu: |
article |
| ISSN: |
2475-0328 |
| DOI: |
10.1002/ags3.12592 |
| Popis: |
Abstract Aim In Japan, we have not been able to validate the results of laparoscopic surgery for locally advanced rectal cancer using the universal index “circumferential resection margin (CRM).” Previously, we established a semi‐opened circular specimen processing method and validated its feasibility. In the PRODUCT trial, we aimed to assess CRM in patients with locally advanced rectal cancer who underwent laparoscopic rectal resection. Methods This was a multicenter, prospective, observational study. Eligible patients had histologically confirmed rectal adenocarcinoma located at or below 12 cm above the anal verge with clinical stage II or III and were scheduled for laparoscopic or robotic surgery. The primary endpoint was pathological CRM. CRM ≤1 mm was defined as positive. Results A total of 303 patients operated on between August 2018 and January 2020 were included in the primary analysis. The number of patients with clinical stage II and III was 139 and 164, respectively. Upfront surgery was performed for 213 patients and neoadjuvant therapy for 90 patients. The median CRM was 4.0 mm (IQR, 2.1‐8.0 mm), and CRM was positive in 26 cases (8.6%). Univariate and multivariate analyses demonstrated that a predicted CRM from the mesorectal fascia of ≤1 mm on MRI was the significant factor for positive CRM (P = .0012 and P = .0045, respectively). Conclusion This study showed the quality of laparoscopic rectal resection based on the CRM in Japan. Preoperative MRI is recommended for locally advanced rectal cancer to prevent CRM positivity. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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