Results of laparoscopic anterior resection for rectal adenocarcinoma: retrospective analysis of 157 cases
Abstract Background Laparoscopic excision of rectal tumors has gained favor in the last decade and several issues have reported encouraging results: still, the use of laparoscopy remains open to debate. The aim of the current study is to assess the reliability of laparoscopic anterior resection (LAR...
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| Veröffentlicht in: | The American journal of surgery 2008-02, Vol.195 (2), p.233-238 |
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| creator | Pugliese, Raffaele, M.D Di Lernia, Stefano, M.D Sansonna, Fabio, M.D Scandroglio, Ildo, M.D Maggioni, Dario, M.D Ferrari, Giovanni Carlo, M.D Costanzi, Andrea, M.D Magistro, Carmelo, M.D De Carli, Stefano, M.D |
| description | Abstract Background Laparoscopic excision of rectal tumors has gained favor in the last decade and several issues have reported encouraging results: still, the use of laparoscopy remains open to debate. The aim of the current study is to assess the reliability of laparoscopic anterior resection (LAR) for rectal cancer analyzing short-term outcomes and long-term survival. Methods The charts of 157 patients were reviewed retrospectively after anterior resection for rectal adenocarcinoma performed by minimal access. Patients undergoing emergency surgery were excluded. LAR was excluded in presence of preoperative features at computed tomography (CT) scan suggesting bulky tumors unresectable by laparoscopy or in case of anesthesiologic contraindications. Conversion rate and functional and oncologic outcomes were analyzed. Data on long-term results and survival were evaluated. Results LAR was performed in 157 patients, and conversion to laparotomy was required in 12 cases. Mean operation time for nonconverted patients was 229 minutes (overall 238 minutes). Total mesorectal excision (TME) was performed in tumors of the mid and low rectum and a temporary ileostomy was performed in 56 patients. The mean length of hospital stay (LOS) was 10.5 days. Morbidity of anterior resection included 17 anastomotic leaks after laparoscopic surgery (LS; 5 in the converted patients). Conversion increased significantly the risk of leak ( P < .005). Two leaks caused death. The mean number of nodes collected was 12. The incidence of local relapse was 4%, and the rate of anastomotic recurrence was nil. Survival probability with LS was .73 at 5 years. Patients in stage III took advantage of adjuvant treatment and had a better survival than patients in stage II ( P = not significant [NS]). Conclusions The outcomes of this study suggest that LAR for rectal cancer is a reliable procedure. Oncologic requirements were respected; parameters such as length of specimen, distal margin, and number of nodes retrieved were quite acceptable. Incidences of local recurrence and long-term survival were comparable with those of other series. |
| doi_str_mv | 10.1016/j.amjsurg.2007.02.020 |
| format | Article |
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The aim of the current study is to assess the reliability of laparoscopic anterior resection (LAR) for rectal cancer analyzing short-term outcomes and long-term survival. Methods The charts of 157 patients were reviewed retrospectively after anterior resection for rectal adenocarcinoma performed by minimal access. Patients undergoing emergency surgery were excluded. LAR was excluded in presence of preoperative features at computed tomography (CT) scan suggesting bulky tumors unresectable by laparoscopy or in case of anesthesiologic contraindications. Conversion rate and functional and oncologic outcomes were analyzed. Data on long-term results and survival were evaluated. Results LAR was performed in 157 patients, and conversion to laparotomy was required in 12 cases. Mean operation time for nonconverted patients was 229 minutes (overall 238 minutes). Total mesorectal excision (TME) was performed in tumors of the mid and low rectum and a temporary ileostomy was performed in 56 patients. The mean length of hospital stay (LOS) was 10.5 days. Morbidity of anterior resection included 17 anastomotic leaks after laparoscopic surgery (LS; 5 in the converted patients). Conversion increased significantly the risk of leak ( P < .005). Two leaks caused death. The mean number of nodes collected was 12. The incidence of local relapse was 4%, and the rate of anastomotic recurrence was nil. Survival probability with LS was .73 at 5 years. Patients in stage III took advantage of adjuvant treatment and had a better survival than patients in stage II ( P = not significant [NS]). Conclusions The outcomes of this study suggest that LAR for rectal cancer is a reliable procedure. Oncologic requirements were respected; parameters such as length of specimen, distal margin, and number of nodes retrieved were quite acceptable. Incidences of local recurrence and long-term survival were comparable with those of other series.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2007.02.020</identifier><identifier>PMID: 18083137</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Anastomosis, Surgical - adverse effects ; Anastomosis, Surgical - methods ; Anterior resection ; Biological and medical sciences ; Biomarkers ; Cancer therapies ; Chemotherapy, Adjuvant ; Chi-Square Distribution ; Cohort Studies ; Confidence Intervals ; Dissection ; Female ; Follow-Up Studies ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Humans ; Italy ; Laparoscopic surgery ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Male ; Medical imaging ; Medical sciences ; Middle Aged ; Molecular weight ; Mortality ; Neoplasm Invasiveness - pathology ; Neoplasm Staging ; NMR ; Nuclear magnetic resonance ; Ostomy ; Postoperative Complications - mortality ; Probability ; Radiotherapy, Adjuvant ; Rectal cancer ; Rectal Neoplasms - mortality ; Rectal Neoplasms - pathology ; Rectal Neoplasms - surgery ; Rectal Neoplasms - therapy ; Retrospective Studies ; Risk Assessment ; Statistical analysis ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Survival Analysis ; Total mesorectal excision ; Treatment Outcome ; Tumors</subject><ispartof>The American journal of surgery, 2008-02, Vol.195 (2), p.233-238</ispartof><rights>Excerpta Medica Inc.</rights><rights>2008 Excerpta Medica Inc.</rights><rights>2008 INIST-CNRS</rights><rights>Copyright Elsevier Limited Feb 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c542t-43e8654631fde5a7eb17c834aa85e3205c06666f9d35a3025c35e270af53cf3d3</citedby><cites>FETCH-LOGICAL-c542t-43e8654631fde5a7eb17c834aa85e3205c06666f9d35a3025c35e270af53cf3d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1444856023?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20059305$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18083137$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pugliese, Raffaele, M.D</creatorcontrib><creatorcontrib>Di Lernia, Stefano, M.D</creatorcontrib><creatorcontrib>Sansonna, Fabio, M.D</creatorcontrib><creatorcontrib>Scandroglio, Ildo, M.D</creatorcontrib><creatorcontrib>Maggioni, Dario, M.D</creatorcontrib><creatorcontrib>Ferrari, Giovanni Carlo, M.D</creatorcontrib><creatorcontrib>Costanzi, Andrea, M.D</creatorcontrib><creatorcontrib>Magistro, Carmelo, M.D</creatorcontrib><creatorcontrib>De Carli, Stefano, M.D</creatorcontrib><title>Results of laparoscopic anterior resection for rectal adenocarcinoma: retrospective analysis of 157 cases</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Laparoscopic excision of rectal tumors has gained favor in the last decade and several issues have reported encouraging results: still, the use of laparoscopy remains open to debate. The aim of the current study is to assess the reliability of laparoscopic anterior resection (LAR) for rectal cancer analyzing short-term outcomes and long-term survival. Methods The charts of 157 patients were reviewed retrospectively after anterior resection for rectal adenocarcinoma performed by minimal access. Patients undergoing emergency surgery were excluded. LAR was excluded in presence of preoperative features at computed tomography (CT) scan suggesting bulky tumors unresectable by laparoscopy or in case of anesthesiologic contraindications. Conversion rate and functional and oncologic outcomes were analyzed. Data on long-term results and survival were evaluated. Results LAR was performed in 157 patients, and conversion to laparotomy was required in 12 cases. Mean operation time for nonconverted patients was 229 minutes (overall 238 minutes). Total mesorectal excision (TME) was performed in tumors of the mid and low rectum and a temporary ileostomy was performed in 56 patients. The mean length of hospital stay (LOS) was 10.5 days. Morbidity of anterior resection included 17 anastomotic leaks after laparoscopic surgery (LS; 5 in the converted patients). Conversion increased significantly the risk of leak ( P < .005). Two leaks caused death. The mean number of nodes collected was 12. The incidence of local relapse was 4%, and the rate of anastomotic recurrence was nil. Survival probability with LS was .73 at 5 years. Patients in stage III took advantage of adjuvant treatment and had a better survival than patients in stage II ( P = not significant [NS]). Conclusions The outcomes of this study suggest that LAR for rectal cancer is a reliable procedure. Oncologic requirements were respected; parameters such as length of specimen, distal margin, and number of nodes retrieved were quite acceptable. Incidences of local recurrence and long-term survival were comparable with those of other series.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anastomosis, Surgical - adverse effects</subject><subject>Anastomosis, Surgical - methods</subject><subject>Anterior resection</subject><subject>Biological and medical sciences</subject><subject>Biomarkers</subject><subject>Cancer therapies</subject><subject>Chemotherapy, Adjuvant</subject><subject>Chi-Square Distribution</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Dissection</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Humans</subject><subject>Italy</subject><subject>Laparoscopic surgery</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Molecular weight</subject><subject>Mortality</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Staging</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Ostomy</subject><subject>Postoperative Complications - mortality</subject><subject>Probability</subject><subject>Radiotherapy, Adjuvant</subject><subject>Rectal cancer</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectal Neoplasms - therapy</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Statistical analysis</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Survival Analysis</subject><subject>Total mesorectal excision</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkl2L1TAQhoMo7nH1JygF0bseJ03T5nixIotfsCD4cR1m06mktk3NtAvn35vuKS7sjSEQJjzvm-SdCPFcwl6CrN50exw6XuKvfQFQ76FIEx6InTT1IZfGqIdiBwBFfqgknIknzF0qpSzVY3EmDRglVb0T_hvx0s-chTbrccIY2IXJuwzHmaIPMYvE5GYfxqy9rdyMfYYNjcFhdH4MA75N23NSTit4Q0mL_ZH9ranUdeaQiZ-KRy32TM-29Vz8_Pjhx-Xn_Orrpy-X769yp8tizktFptJlpWTbkMaarmXtjCoRjSZVgHZQpdEeGqVRQaGd0lTUgK1WrlWNOhevT75TDH8W4tkOnh31PY4UFrZ1ysmkfBL48h7YhSWmq7OVZVkaXUGxUvpEufRAjtTaKfoB49FKsGsnbGe3Tti1ExaKNCHpXmzuy_VAzZ1qiz4BrzYA2WHfRhyd539c8tIHBTpx704cpdBuPEXLztPoqPFrM2wT_H-vcnHPwfV-9OnQ33Qkvnu15SSw39dvs_4aqCElVdbqLw84vm8</recordid><startdate>20080201</startdate><enddate>20080201</enddate><creator>Pugliese, Raffaele, M.D</creator><creator>Di Lernia, Stefano, M.D</creator><creator>Sansonna, Fabio, M.D</creator><creator>Scandroglio, Ildo, M.D</creator><creator>Maggioni, Dario, M.D</creator><creator>Ferrari, Giovanni Carlo, M.D</creator><creator>Costanzi, Andrea, M.D</creator><creator>Magistro, Carmelo, M.D</creator><creator>De Carli, Stefano, M.D</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20080201</creationdate><title>Results of laparoscopic anterior resection for rectal adenocarcinoma: retrospective analysis of 157 cases</title><author>Pugliese, Raffaele, M.D ; Di Lernia, Stefano, M.D ; Sansonna, Fabio, M.D ; Scandroglio, Ildo, M.D ; Maggioni, Dario, M.D ; Ferrari, Giovanni Carlo, M.D ; Costanzi, Andrea, M.D ; Magistro, Carmelo, M.D ; De Carli, Stefano, M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c542t-43e8654631fde5a7eb17c834aa85e3205c06666f9d35a3025c35e270af53cf3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adenocarcinoma - therapy</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anastomosis, Surgical - adverse effects</topic><topic>Anastomosis, Surgical - methods</topic><topic>Anterior resection</topic><topic>Biological and medical sciences</topic><topic>Biomarkers</topic><topic>Cancer therapies</topic><topic>Chemotherapy, Adjuvant</topic><topic>Chi-Square Distribution</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Dissection</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Humans</topic><topic>Italy</topic><topic>Laparoscopic surgery</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Molecular weight</topic><topic>Mortality</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Staging</topic><topic>NMR</topic><topic>Nuclear magnetic resonance</topic><topic>Ostomy</topic><topic>Postoperative Complications - mortality</topic><topic>Probability</topic><topic>Radiotherapy, Adjuvant</topic><topic>Rectal cancer</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectal Neoplasms - therapy</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Statistical analysis</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Survival Analysis</topic><topic>Total mesorectal excision</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pugliese, Raffaele, M.D</creatorcontrib><creatorcontrib>Di Lernia, Stefano, M.D</creatorcontrib><creatorcontrib>Sansonna, Fabio, M.D</creatorcontrib><creatorcontrib>Scandroglio, Ildo, M.D</creatorcontrib><creatorcontrib>Maggioni, Dario, M.D</creatorcontrib><creatorcontrib>Ferrari, Giovanni Carlo, M.D</creatorcontrib><creatorcontrib>Costanzi, Andrea, M.D</creatorcontrib><creatorcontrib>Magistro, Carmelo, M.D</creatorcontrib><creatorcontrib>De Carli, Stefano, M.D</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pugliese, Raffaele, M.D</au><au>Di Lernia, Stefano, M.D</au><au>Sansonna, Fabio, M.D</au><au>Scandroglio, Ildo, M.D</au><au>Maggioni, Dario, M.D</au><au>Ferrari, Giovanni Carlo, M.D</au><au>Costanzi, Andrea, M.D</au><au>Magistro, Carmelo, M.D</au><au>De Carli, Stefano, M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Results of laparoscopic anterior resection for rectal adenocarcinoma: retrospective analysis of 157 cases</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2008-02-01</date><risdate>2008</risdate><volume>195</volume><issue>2</issue><spage>233</spage><epage>238</epage><pages>233-238</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background Laparoscopic excision of rectal tumors has gained favor in the last decade and several issues have reported encouraging results: still, the use of laparoscopy remains open to debate. The aim of the current study is to assess the reliability of laparoscopic anterior resection (LAR) for rectal cancer analyzing short-term outcomes and long-term survival. Methods The charts of 157 patients were reviewed retrospectively after anterior resection for rectal adenocarcinoma performed by minimal access. Patients undergoing emergency surgery were excluded. LAR was excluded in presence of preoperative features at computed tomography (CT) scan suggesting bulky tumors unresectable by laparoscopy or in case of anesthesiologic contraindications. Conversion rate and functional and oncologic outcomes were analyzed. Data on long-term results and survival were evaluated. Results LAR was performed in 157 patients, and conversion to laparotomy was required in 12 cases. Mean operation time for nonconverted patients was 229 minutes (overall 238 minutes). Total mesorectal excision (TME) was performed in tumors of the mid and low rectum and a temporary ileostomy was performed in 56 patients. The mean length of hospital stay (LOS) was 10.5 days. Morbidity of anterior resection included 17 anastomotic leaks after laparoscopic surgery (LS; 5 in the converted patients). Conversion increased significantly the risk of leak ( P < .005). Two leaks caused death. The mean number of nodes collected was 12. The incidence of local relapse was 4%, and the rate of anastomotic recurrence was nil. Survival probability with LS was .73 at 5 years. Patients in stage III took advantage of adjuvant treatment and had a better survival than patients in stage II ( P = not significant [NS]). Conclusions The outcomes of this study suggest that LAR for rectal cancer is a reliable procedure. Oncologic requirements were respected; parameters such as length of specimen, distal margin, and number of nodes retrieved were quite acceptable. Incidences of local recurrence and long-term survival were comparable with those of other series.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18083137</pmid><doi>10.1016/j.amjsurg.2007.02.020</doi><tpages>6</tpages></addata></record> |
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| ispartof | The American journal of surgery, 2008-02, Vol.195 (2), p.233-238 |
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| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adenocarcinoma - therapy Adult Aged Aged, 80 and over Anastomosis, Surgical - adverse effects Anastomosis, Surgical - methods Anterior resection Biological and medical sciences Biomarkers Cancer therapies Chemotherapy, Adjuvant Chi-Square Distribution Cohort Studies Confidence Intervals Dissection Female Follow-Up Studies Gastroenterology. Liver. Pancreas. Abdomen General aspects Humans Italy Laparoscopic surgery Laparoscopy - adverse effects Laparoscopy - methods Male Medical imaging Medical sciences Middle Aged Molecular weight Mortality Neoplasm Invasiveness - pathology Neoplasm Staging NMR Nuclear magnetic resonance Ostomy Postoperative Complications - mortality Probability Radiotherapy, Adjuvant Rectal cancer Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - surgery Rectal Neoplasms - therapy Retrospective Studies Risk Assessment Statistical analysis Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Survival Analysis Total mesorectal excision Treatment Outcome Tumors |
| title | Results of laparoscopic anterior resection for rectal adenocarcinoma: retrospective analysis of 157 cases |
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