Laparoscopic total mesorectal excision for rectal cancer: experience of a single center with a series of 174 patients
Background Laparoscopic total mesorectal excision for low rectal cancer is not considered a gold standard treatment due to the high conversion rate and the long operation time. Methods A retrospective review examined a surgical series of 174 laparoscopic low rectal resections involving total mesorec...
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| Veröffentlicht in: | Surgical endoscopy 2011-02, Vol.25 (2), p.508-514 |
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| creator | Sartori, C. A. Dal Pozzo, A. Franzato, B. Balduino, M. Sartori, A. Baiocchi, G. L. |
| description | Background
Laparoscopic total mesorectal excision for low rectal cancer is not considered a gold standard treatment due to the high conversion rate and the long operation time.
Methods
A retrospective review examined a surgical series of 174 laparoscopic low rectal resections involving total mesorectal excision (1995–2006), with particular reference to technical points as well as surgical and oncologic outcomes. Miles operations and partial mesorectal excisions were excluded.
Results
The cancer affected the low rectum in 110 cases and the medium rectum in 64 cases. A total of 68 patients were subjected to neoadjuvant radiochemotherapy. The anastomosis was mechanical for 83.3% of the cases and intersphinteric through the perineum for 16.6% of the cases. Protective ileostomy was performed in 112 cases. The conversion rate was 4.6%. The mesorectum remained intact in 91.6% of the cases and was partially interrupted in 15 of the cases. In no case was it totally discontinued. The postoperative morbidity rate was 16.7%, and the mortality rate was 0.57%. The incidence of anastomotic fistulas was 14.4%. The percentage was higher for males (18.6 vs 8.3%) and correlated with the low distance of the tumor from the anal verge (18.2 vs 7.8%) and the absence of a protection ileostomy (20.9 vs 10.7%). After an average follow-up period of 48.6 months (range, 24–149 months), six patients (3.44%) experienced a pelvic recurrence. The 5-year overall survival rate was 75.4%, and the disease-free survival rate was 61.9%.
Conclusion
Laparoscopic total mesorectal excision for low rectal cancer is safe and effective, allowing surgical and oncologic outcomes similar to those reported for open surgery. |
| doi_str_mv | 10.1007/s00464-010-1202-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_849011383</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2254350331</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-9a36ece4090041f6da764283729d809be0de8802eff8f7ee50556286edaa37693</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhoMo7uzqD_AiQRBPrZWPTifeZPELBrzoucmmK2uWnk6b6mZ1f71pZnRB8JRU1VNvFfUy9kzAawHQvSEAbXQDAhohQTZ3D9hOaCUbKYV9yHbgFDSyc_qMnRPdQMWdaB-zMwkGutbAjq17P_uSKeQ5Bb7kxY_8gJQLhu2LP0OilCcec-GnXPBTwPK21mYsCWvAc-SeU5quR-QBpwULv03L9y25IbQBotN89kttWOgJexT9SPj09F6wbx_ef7381Oy_fPx8-W7fBA2wNM4rgwE1uLq5iGbwndHSqk66wYK7QhjQWpAYo40dYgtta6Q1OHivOuPUBXt11J1L_rEiLf0hUcBx9BPmlXqrHQihrKrki3_Im7yWqS5XIdtaYdtNThyhUC9GBWM_l3Tw5VcvoN8c6Y-O9LDF1ZH-rvY8PwmvVwcc_nb8saACL0-Ap-DHWOp5E91zyglh7DZcHjmqpekay_2G_5_-G1qPo1c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>848581859</pqid></control><display><type>article</type><title>Laparoscopic total mesorectal excision for rectal cancer: experience of a single center with a series of 174 patients</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Sartori, C. A. ; Dal Pozzo, A. ; Franzato, B. ; Balduino, M. ; Sartori, A. ; Baiocchi, G. L.</creator><creatorcontrib>Sartori, C. A. ; Dal Pozzo, A. ; Franzato, B. ; Balduino, M. ; Sartori, A. ; Baiocchi, G. L.</creatorcontrib><description>Background
Laparoscopic total mesorectal excision for low rectal cancer is not considered a gold standard treatment due to the high conversion rate and the long operation time.
Methods
A retrospective review examined a surgical series of 174 laparoscopic low rectal resections involving total mesorectal excision (1995–2006), with particular reference to technical points as well as surgical and oncologic outcomes. Miles operations and partial mesorectal excisions were excluded.
Results
The cancer affected the low rectum in 110 cases and the medium rectum in 64 cases. A total of 68 patients were subjected to neoadjuvant radiochemotherapy. The anastomosis was mechanical for 83.3% of the cases and intersphinteric through the perineum for 16.6% of the cases. Protective ileostomy was performed in 112 cases. The conversion rate was 4.6%. The mesorectum remained intact in 91.6% of the cases and was partially interrupted in 15 of the cases. In no case was it totally discontinued. The postoperative morbidity rate was 16.7%, and the mortality rate was 0.57%. The incidence of anastomotic fistulas was 14.4%. The percentage was higher for males (18.6 vs 8.3%) and correlated with the low distance of the tumor from the anal verge (18.2 vs 7.8%) and the absence of a protection ileostomy (20.9 vs 10.7%). After an average follow-up period of 48.6 months (range, 24–149 months), six patients (3.44%) experienced a pelvic recurrence. The 5-year overall survival rate was 75.4%, and the disease-free survival rate was 61.9%.
Conclusion
Laparoscopic total mesorectal excision for low rectal cancer is safe and effective, allowing surgical and oncologic outcomes similar to those reported for open surgery.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-010-1202-z</identifier><identifier>PMID: 20607560</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdomen ; Abdominal Surgery ; Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Adult ; Aged ; Aged, 80 and over ; Anal Canal ; Anastomosis, Surgical - methods ; Biological and medical sciences ; Cohort Studies ; Colorectal cancer ; Digestive system. Abdomen ; Disease-Free Survival ; Endoscopy ; Female ; Follow-Up Studies ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; Gynecology ; Hepatology ; Humans ; Intestinal Mucosa - pathology ; Intestinal Mucosa - surgery ; Investigative techniques, diagnostic techniques (general aspects) ; Kaplan-Meier Estimate ; Laparoscopy ; Laparoscopy - adverse effects ; Laparoscopy - methods ; Male ; Medical imaging ; Medical prognosis ; Medical sciences ; Medicine ; Medicine & Public Health ; Metastasis ; Middle Aged ; Mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Ostomy ; Postoperative Complications - physiopathology ; Postoperative Complications - surgery ; Proctology ; Proctoscopy - methods ; Rectal Neoplasms - mortality ; Rectal Neoplasms - pathology ; Rectal Neoplasms - surgery ; Rectum ; Retrospective Studies ; Risk Assessment ; Stomach, duodenum, intestine, rectum, anus ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Survival Rate ; Time Factors ; Treatment Outcome ; Tumors ; Ultrasonic imaging</subject><ispartof>Surgical endoscopy, 2011-02, Vol.25 (2), p.508-514</ispartof><rights>Springer Science+Business Media, LLC 2010</rights><rights>2015 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2011</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-9a36ece4090041f6da764283729d809be0de8802eff8f7ee50556286edaa37693</citedby><cites>FETCH-LOGICAL-c400t-9a36ece4090041f6da764283729d809be0de8802eff8f7ee50556286edaa37693</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-010-1202-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-010-1202-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23911689$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20607560$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sartori, C. A.</creatorcontrib><creatorcontrib>Dal Pozzo, A.</creatorcontrib><creatorcontrib>Franzato, B.</creatorcontrib><creatorcontrib>Balduino, M.</creatorcontrib><creatorcontrib>Sartori, A.</creatorcontrib><creatorcontrib>Baiocchi, G. L.</creatorcontrib><title>Laparoscopic total mesorectal excision for rectal cancer: experience of a single center with a series of 174 patients</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Laparoscopic total mesorectal excision for low rectal cancer is not considered a gold standard treatment due to the high conversion rate and the long operation time.
Methods
A retrospective review examined a surgical series of 174 laparoscopic low rectal resections involving total mesorectal excision (1995–2006), with particular reference to technical points as well as surgical and oncologic outcomes. Miles operations and partial mesorectal excisions were excluded.
Results
The cancer affected the low rectum in 110 cases and the medium rectum in 64 cases. A total of 68 patients were subjected to neoadjuvant radiochemotherapy. The anastomosis was mechanical for 83.3% of the cases and intersphinteric through the perineum for 16.6% of the cases. Protective ileostomy was performed in 112 cases. The conversion rate was 4.6%. The mesorectum remained intact in 91.6% of the cases and was partially interrupted in 15 of the cases. In no case was it totally discontinued. The postoperative morbidity rate was 16.7%, and the mortality rate was 0.57%. The incidence of anastomotic fistulas was 14.4%. The percentage was higher for males (18.6 vs 8.3%) and correlated with the low distance of the tumor from the anal verge (18.2 vs 7.8%) and the absence of a protection ileostomy (20.9 vs 10.7%). After an average follow-up period of 48.6 months (range, 24–149 months), six patients (3.44%) experienced a pelvic recurrence. The 5-year overall survival rate was 75.4%, and the disease-free survival rate was 61.9%.
Conclusion
Laparoscopic total mesorectal excision for low rectal cancer is safe and effective, allowing surgical and oncologic outcomes similar to those reported for open surgery.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anal Canal</subject><subject>Anastomosis, Surgical - methods</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Colorectal cancer</subject><subject>Digestive system. Abdomen</subject><subject>Disease-Free Survival</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Intestinal Mucosa - pathology</subject><subject>Intestinal Mucosa - surgery</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Kaplan-Meier Estimate</subject><subject>Laparoscopy</subject><subject>Laparoscopy - adverse effects</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical prognosis</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Ostomy</subject><subject>Postoperative Complications - physiopathology</subject><subject>Postoperative Complications - surgery</subject><subject>Proctology</subject><subject>Proctoscopy - methods</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Rectum</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Survival Rate</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Ultrasonic imaging</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kU2LFDEQhoMo7uzqD_AiQRBPrZWPTifeZPELBrzoucmmK2uWnk6b6mZ1f71pZnRB8JRU1VNvFfUy9kzAawHQvSEAbXQDAhohQTZ3D9hOaCUbKYV9yHbgFDSyc_qMnRPdQMWdaB-zMwkGutbAjq17P_uSKeQ5Bb7kxY_8gJQLhu2LP0OilCcec-GnXPBTwPK21mYsCWvAc-SeU5quR-QBpwULv03L9y25IbQBotN89kttWOgJexT9SPj09F6wbx_ef7381Oy_fPx8-W7fBA2wNM4rgwE1uLq5iGbwndHSqk66wYK7QhjQWpAYo40dYgtta6Q1OHivOuPUBXt11J1L_rEiLf0hUcBx9BPmlXqrHQihrKrki3_Im7yWqS5XIdtaYdtNThyhUC9GBWM_l3Tw5VcvoN8c6Y-O9LDF1ZH-rvY8PwmvVwcc_nb8saACL0-Ap-DHWOp5E91zyglh7DZcHjmqpekay_2G_5_-G1qPo1c</recordid><startdate>20110201</startdate><enddate>20110201</enddate><creator>Sartori, C. A.</creator><creator>Dal Pozzo, A.</creator><creator>Franzato, B.</creator><creator>Balduino, M.</creator><creator>Sartori, A.</creator><creator>Baiocchi, G. L.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</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>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20110201</creationdate><title>Laparoscopic total mesorectal excision for rectal cancer: experience of a single center with a series of 174 patients</title><author>Sartori, C. A. ; Dal Pozzo, A. ; Franzato, B. ; Balduino, M. ; Sartori, A. ; Baiocchi, G. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-9a36ece4090041f6da764283729d809be0de8802eff8f7ee50556286edaa37693</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Adenocarcinoma - mortality</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anal Canal</topic><topic>Anastomosis, Surgical - methods</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Colorectal cancer</topic><topic>Digestive system. Abdomen</topic><topic>Disease-Free Survival</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Intestinal Mucosa - pathology</topic><topic>Intestinal Mucosa - surgery</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Kaplan-Meier Estimate</topic><topic>Laparoscopy</topic><topic>Laparoscopy - adverse effects</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical prognosis</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Ostomy</topic><topic>Postoperative Complications - physiopathology</topic><topic>Postoperative Complications - surgery</topic><topic>Proctology</topic><topic>Proctoscopy - methods</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Rectum</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Survival Rate</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Ultrasonic imaging</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sartori, C. A.</creatorcontrib><creatorcontrib>Dal Pozzo, A.</creatorcontrib><creatorcontrib>Franzato, B.</creatorcontrib><creatorcontrib>Balduino, M.</creatorcontrib><creatorcontrib>Sartori, A.</creatorcontrib><creatorcontrib>Baiocchi, G. L.</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>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</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>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sartori, C. A.</au><au>Dal Pozzo, A.</au><au>Franzato, B.</au><au>Balduino, M.</au><au>Sartori, A.</au><au>Baiocchi, G. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic total mesorectal excision for rectal cancer: experience of a single center with a series of 174 patients</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2011-02-01</date><risdate>2011</risdate><volume>25</volume><issue>2</issue><spage>508</spage><epage>514</epage><pages>508-514</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Laparoscopic total mesorectal excision for low rectal cancer is not considered a gold standard treatment due to the high conversion rate and the long operation time.
Methods
A retrospective review examined a surgical series of 174 laparoscopic low rectal resections involving total mesorectal excision (1995–2006), with particular reference to technical points as well as surgical and oncologic outcomes. Miles operations and partial mesorectal excisions were excluded.
Results
The cancer affected the low rectum in 110 cases and the medium rectum in 64 cases. A total of 68 patients were subjected to neoadjuvant radiochemotherapy. The anastomosis was mechanical for 83.3% of the cases and intersphinteric through the perineum for 16.6% of the cases. Protective ileostomy was performed in 112 cases. The conversion rate was 4.6%. The mesorectum remained intact in 91.6% of the cases and was partially interrupted in 15 of the cases. In no case was it totally discontinued. The postoperative morbidity rate was 16.7%, and the mortality rate was 0.57%. The incidence of anastomotic fistulas was 14.4%. The percentage was higher for males (18.6 vs 8.3%) and correlated with the low distance of the tumor from the anal verge (18.2 vs 7.8%) and the absence of a protection ileostomy (20.9 vs 10.7%). After an average follow-up period of 48.6 months (range, 24–149 months), six patients (3.44%) experienced a pelvic recurrence. The 5-year overall survival rate was 75.4%, and the disease-free survival rate was 61.9%.
Conclusion
Laparoscopic total mesorectal excision for low rectal cancer is safe and effective, allowing surgical and oncologic outcomes similar to those reported for open surgery.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>20607560</pmid><doi>10.1007/s00464-010-1202-z</doi><tpages>7</tpages></addata></record> |
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| ispartof | Surgical endoscopy, 2011-02, Vol.25 (2), p.508-514 |
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| subjects | Abdomen Abdominal Surgery Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - surgery Adult Aged Aged, 80 and over Anal Canal Anastomosis, Surgical - methods Biological and medical sciences Cohort Studies Colorectal cancer Digestive system. Abdomen Disease-Free Survival Endoscopy Female Follow-Up Studies Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen Gynecology Hepatology Humans Intestinal Mucosa - pathology Intestinal Mucosa - surgery Investigative techniques, diagnostic techniques (general aspects) Kaplan-Meier Estimate Laparoscopy Laparoscopy - adverse effects Laparoscopy - methods Male Medical imaging Medical prognosis Medical sciences Medicine Medicine & Public Health Metastasis Middle Aged Mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Staging Ostomy Postoperative Complications - physiopathology Postoperative Complications - surgery Proctology Proctoscopy - methods Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - surgery Rectum Retrospective Studies Risk Assessment Stomach, duodenum, intestine, rectum, anus Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Survival Rate Time Factors Treatment Outcome Tumors Ultrasonic imaging |
| title | Laparoscopic total mesorectal excision for rectal cancer: experience of a single center with a series of 174 patients |
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