Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes
Background Neoadjuvant chemoradiation (nCRT) currently is commonly incorporated into the multimodal treatment of locally advanced rectal cancers. This study aimed to compare the short-term outcomes and oncologic adequacy of laparoscopic and conventional open surgery for rectal cancer after nCRT. Met...
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| Veröffentlicht in: | Surgical endoscopy 2012, Vol.26 (1), p.154-161 |
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| creator | Seshadri, Ramakrishnan Ayloor Srinivasan, Ayyappan Tapkire, Ritesh Swaminathan, Rajaraman |
| description | Background
Neoadjuvant chemoradiation (nCRT) currently is commonly incorporated into the multimodal treatment of locally advanced rectal cancers. This study aimed to compare the short-term outcomes and oncologic adequacy of laparoscopic and conventional open surgery for rectal cancer after nCRT.
Methods
A series of 72 patients who underwent laparoscopic surgery (Lap group) for rectal cancer after nCRT were matched for type of surgery, gender, and American Society of Anesthesiologists (ASA) class with 72 patients who underwent conventional surgery during the same time period (Open group). The short-term outcomes were compared between the two groups of patients.
Results
No significant difference was found between the two groups in terms of age, distance of tumor from the anal verge, body mass index, or posttreatment pathologic stage of the disease. There were significant differences between the Lap and Open groups in terms of blood loss (median: 200 vs 400 ml;
P
|
| doi_str_mv | 10.1007/s00464-011-1844-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_912273222</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2542465071</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-9697a65e63118ea569106c41bb2c14c7769d9e41a31ed4f7ced36456a3a264f33</originalsourceid><addsrcrecordid>eNp1kU2LFDEQhoMo7rj6A7xIEMRTNJWvnniTxS8Y8KLnpiZd7fbQ3WmT9ML8A3-2GWZ0QfCSQPK8lUo9jD0H-QakbN5mKY0zQgII2Boj7AO2AaOVUAq2D9lGei2Fary5Yk9yPsiKe7CP2ZWCxqsG9Ib92uGCKeYQlyHwO0p5zTwuNPO8ph-UjryPiScKBUcecA6UOPalrjNF7A7rHc6Fh1uaYsJuwDLE-R1HPmGph12NZBIhziXFkeeydkcee55vYyqiVpl4XEuIE-Wn7FGPY6Znl_2aff_44dvNZ7H7-unLzfudCEbKIrzzDTpLTgNsCa3zIF0wsN-rACY0jfOdJwOogTrTN4E67Yx1qFE502t9zV6f6y4p_lwpl3YacqBxxPqhNbcelGq0UqqSL_8hD3FNc22uQuCV1cZWCM5QqEPMifp2ScOE6diCbE-S2rOktkpqT5LaU-bFpfC6n6j7m_hjpQKvLgDmgGOf6tyHfM9Za6XRUDl15nK9mqut-w7___pvp0qrIg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>911925345</pqid></control><display><type>article</type><title>Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Seshadri, Ramakrishnan Ayloor ; Srinivasan, Ayyappan ; Tapkire, Ritesh ; Swaminathan, Rajaraman</creator><creatorcontrib>Seshadri, Ramakrishnan Ayloor ; Srinivasan, Ayyappan ; Tapkire, Ritesh ; Swaminathan, Rajaraman</creatorcontrib><description>Background
Neoadjuvant chemoradiation (nCRT) currently is commonly incorporated into the multimodal treatment of locally advanced rectal cancers. This study aimed to compare the short-term outcomes and oncologic adequacy of laparoscopic and conventional open surgery for rectal cancer after nCRT.
Methods
A series of 72 patients who underwent laparoscopic surgery (Lap group) for rectal cancer after nCRT were matched for type of surgery, gender, and American Society of Anesthesiologists (ASA) class with 72 patients who underwent conventional surgery during the same time period (Open group). The short-term outcomes were compared between the two groups of patients.
Results
No significant difference was found between the two groups in terms of age, distance of tumor from the anal verge, body mass index, or posttreatment pathologic stage of the disease. There were significant differences between the Lap and Open groups in terms of blood loss (median: 200 vs 400 ml;
P
< 0.001), duration of surgery (median: 270 vs 240 min;
P
< 0.001), time to passing of first flatus (median: 2 vs 3 days;
P
< 0.001), time to start of normal diet (median: 5 vs 6 days;
P
< 0.001), and hospital stay (median: 12 vs 15 days;
P
< 0.001). A significant difference in the number of lymph nodes harvested was not identified between the two groups, although more patients in the Open group had a positive circumferential resection margin than in the Lap group (10 vs 1%;
P
= 0.03). The short-term benefits of laparoscopic surgery also were observed when the 64 patients who underwent abdominoperineal resection (APR) in each of the two groups were compared separately.
Conclusion
Laparoscopic surgery for rectal cancer, especially laparoscopic APR, after nCRT is safe and associated with earlier recovery of bowel function, a shorter hospital stay, and an oncologically adequate specimen compared with conventional open surgery.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-011-1844-5</identifier><identifier>PMID: 21792713</identifier><identifier>CODEN: SUREEX</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Abdomen ; Abdominal Surgery ; Adult ; Aged ; Antineoplastic agents ; Biological and medical sciences ; Blood Loss, Surgical ; Body mass index ; Cancer therapies ; Case-Control Studies ; Chemotherapy ; Chemotherapy, Adjuvant ; Colorectal cancer ; Combined treatments (chemotherapy of immunotherapy associated with an other treatment) ; Female ; Gastroenterology ; Gastroenterology. Liver. Pancreas. Abdomen ; General aspects ; Gynecology ; Hepatology ; Hospitals ; Humans ; Laparoscopy ; Laparoscopy - methods ; Length of Stay ; Male ; Medical personnel ; Medical sciences ; Medicine ; Medicine & Public Health ; Middle Aged ; Patients ; Pharmacology. Drug treatments ; Proctology ; Radiation ; Radiotherapy, Adjuvant ; Rectal Neoplasms - drug therapy ; Rectal Neoplasms - radiotherapy ; Rectal Neoplasms - surgery ; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus ; Surgery ; Surgical Wound Dehiscence - etiology ; Surgical Wound Infection - etiology ; Treatment Outcome ; Tumors ; Young Adult</subject><ispartof>Surgical endoscopy, 2012, Vol.26 (1), p.154-161</ispartof><rights>Springer Science+Business Media, LLC 2011</rights><rights>2015 INIST-CNRS</rights><rights>Springer Science+Business Media, LLC 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-9697a65e63118ea569106c41bb2c14c7769d9e41a31ed4f7ced36456a3a264f33</citedby><cites>FETCH-LOGICAL-c400t-9697a65e63118ea569106c41bb2c14c7769d9e41a31ed4f7ced36456a3a264f33</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/s00464-011-1844-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-011-1844-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,4010,27900,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=25550431$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21792713$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Seshadri, Ramakrishnan Ayloor</creatorcontrib><creatorcontrib>Srinivasan, Ayyappan</creatorcontrib><creatorcontrib>Tapkire, Ritesh</creatorcontrib><creatorcontrib>Swaminathan, Rajaraman</creatorcontrib><title>Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Neoadjuvant chemoradiation (nCRT) currently is commonly incorporated into the multimodal treatment of locally advanced rectal cancers. This study aimed to compare the short-term outcomes and oncologic adequacy of laparoscopic and conventional open surgery for rectal cancer after nCRT.
Methods
A series of 72 patients who underwent laparoscopic surgery (Lap group) for rectal cancer after nCRT were matched for type of surgery, gender, and American Society of Anesthesiologists (ASA) class with 72 patients who underwent conventional surgery during the same time period (Open group). The short-term outcomes were compared between the two groups of patients.
Results
No significant difference was found between the two groups in terms of age, distance of tumor from the anal verge, body mass index, or posttreatment pathologic stage of the disease. There were significant differences between the Lap and Open groups in terms of blood loss (median: 200 vs 400 ml;
P
< 0.001), duration of surgery (median: 270 vs 240 min;
P
< 0.001), time to passing of first flatus (median: 2 vs 3 days;
P
< 0.001), time to start of normal diet (median: 5 vs 6 days;
P
< 0.001), and hospital stay (median: 12 vs 15 days;
P
< 0.001). A significant difference in the number of lymph nodes harvested was not identified between the two groups, although more patients in the Open group had a positive circumferential resection margin than in the Lap group (10 vs 1%;
P
= 0.03). The short-term benefits of laparoscopic surgery also were observed when the 64 patients who underwent abdominoperineal resection (APR) in each of the two groups were compared separately.
Conclusion
Laparoscopic surgery for rectal cancer, especially laparoscopic APR, after nCRT is safe and associated with earlier recovery of bowel function, a shorter hospital stay, and an oncologically adequate specimen compared with conventional open surgery.</description><subject>Abdomen</subject><subject>Abdominal Surgery</subject><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Biological and medical sciences</subject><subject>Blood Loss, Surgical</subject><subject>Body mass index</subject><subject>Cancer therapies</subject><subject>Case-Control Studies</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Colorectal cancer</subject><subject>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>General aspects</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Pharmacology. Drug treatments</subject><subject>Proctology</subject><subject>Radiation</subject><subject>Radiotherapy, Adjuvant</subject><subject>Rectal Neoplasms - drug therapy</subject><subject>Rectal Neoplasms - radiotherapy</subject><subject>Rectal Neoplasms - surgery</subject><subject>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</subject><subject>Surgery</subject><subject>Surgical Wound Dehiscence - etiology</subject><subject>Surgical Wound Infection - etiology</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU2LFDEQhoMo7rj6A7xIEMRTNJWvnniTxS8Y8KLnpiZd7fbQ3WmT9ML8A3-2GWZ0QfCSQPK8lUo9jD0H-QakbN5mKY0zQgII2Boj7AO2AaOVUAq2D9lGei2Fary5Yk9yPsiKe7CP2ZWCxqsG9Ib92uGCKeYQlyHwO0p5zTwuNPO8ph-UjryPiScKBUcecA6UOPalrjNF7A7rHc6Fh1uaYsJuwDLE-R1HPmGph12NZBIhziXFkeeydkcee55vYyqiVpl4XEuIE-Wn7FGPY6Znl_2aff_44dvNZ7H7-unLzfudCEbKIrzzDTpLTgNsCa3zIF0wsN-rACY0jfOdJwOogTrTN4E67Yx1qFE502t9zV6f6y4p_lwpl3YacqBxxPqhNbcelGq0UqqSL_8hD3FNc22uQuCV1cZWCM5QqEPMifp2ScOE6diCbE-S2rOktkpqT5LaU-bFpfC6n6j7m_hjpQKvLgDmgGOf6tyHfM9Za6XRUDl15nK9mqut-w7___pvp0qrIg</recordid><startdate>2012</startdate><enddate>2012</enddate><creator>Seshadri, Ramakrishnan Ayloor</creator><creator>Srinivasan, Ayyappan</creator><creator>Tapkire, Ritesh</creator><creator>Swaminathan, Rajaraman</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>7X8</scope></search><sort><creationdate>2012</creationdate><title>Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes</title><author>Seshadri, Ramakrishnan Ayloor ; Srinivasan, Ayyappan ; Tapkire, Ritesh ; Swaminathan, Rajaraman</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-9697a65e63118ea569106c41bb2c14c7769d9e41a31ed4f7ced36456a3a264f33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Abdomen</topic><topic>Abdominal Surgery</topic><topic>Adult</topic><topic>Aged</topic><topic>Antineoplastic agents</topic><topic>Biological and medical sciences</topic><topic>Blood Loss, Surgical</topic><topic>Body mass index</topic><topic>Cancer therapies</topic><topic>Case-Control Studies</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Colorectal cancer</topic><topic>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>General aspects</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Pharmacology. Drug treatments</topic><topic>Proctology</topic><topic>Radiation</topic><topic>Radiotherapy, Adjuvant</topic><topic>Rectal Neoplasms - drug therapy</topic><topic>Rectal Neoplasms - radiotherapy</topic><topic>Rectal Neoplasms - surgery</topic><topic>Stomach. Duodenum. Small intestine. Colon. Rectum. Anus</topic><topic>Surgery</topic><topic>Surgical Wound Dehiscence - etiology</topic><topic>Surgical Wound Infection - etiology</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Seshadri, Ramakrishnan Ayloor</creatorcontrib><creatorcontrib>Srinivasan, Ayyappan</creatorcontrib><creatorcontrib>Tapkire, Ritesh</creatorcontrib><creatorcontrib>Swaminathan, Rajaraman</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>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Seshadri, Ramakrishnan Ayloor</au><au>Srinivasan, Ayyappan</au><au>Tapkire, Ritesh</au><au>Swaminathan, Rajaraman</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2012</date><risdate>2012</risdate><volume>26</volume><issue>1</issue><spage>154</spage><epage>161</epage><pages>154-161</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><coden>SUREEX</coden><abstract>Background
Neoadjuvant chemoradiation (nCRT) currently is commonly incorporated into the multimodal treatment of locally advanced rectal cancers. This study aimed to compare the short-term outcomes and oncologic adequacy of laparoscopic and conventional open surgery for rectal cancer after nCRT.
Methods
A series of 72 patients who underwent laparoscopic surgery (Lap group) for rectal cancer after nCRT were matched for type of surgery, gender, and American Society of Anesthesiologists (ASA) class with 72 patients who underwent conventional surgery during the same time period (Open group). The short-term outcomes were compared between the two groups of patients.
Results
No significant difference was found between the two groups in terms of age, distance of tumor from the anal verge, body mass index, or posttreatment pathologic stage of the disease. There were significant differences between the Lap and Open groups in terms of blood loss (median: 200 vs 400 ml;
P
< 0.001), duration of surgery (median: 270 vs 240 min;
P
< 0.001), time to passing of first flatus (median: 2 vs 3 days;
P
< 0.001), time to start of normal diet (median: 5 vs 6 days;
P
< 0.001), and hospital stay (median: 12 vs 15 days;
P
< 0.001). A significant difference in the number of lymph nodes harvested was not identified between the two groups, although more patients in the Open group had a positive circumferential resection margin than in the Lap group (10 vs 1%;
P
= 0.03). The short-term benefits of laparoscopic surgery also were observed when the 64 patients who underwent abdominoperineal resection (APR) in each of the two groups were compared separately.
Conclusion
Laparoscopic surgery for rectal cancer, especially laparoscopic APR, after nCRT is safe and associated with earlier recovery of bowel function, a shorter hospital stay, and an oncologically adequate specimen compared with conventional open surgery.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>21792713</pmid><doi>10.1007/s00464-011-1844-5</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Abdomen Abdominal Surgery Adult Aged Antineoplastic agents Biological and medical sciences Blood Loss, Surgical Body mass index Cancer therapies Case-Control Studies Chemotherapy Chemotherapy, Adjuvant Colorectal cancer Combined treatments (chemotherapy of immunotherapy associated with an other treatment) Female Gastroenterology Gastroenterology. Liver. Pancreas. Abdomen General aspects Gynecology Hepatology Hospitals Humans Laparoscopy Laparoscopy - methods Length of Stay Male Medical personnel Medical sciences Medicine Medicine & Public Health Middle Aged Patients Pharmacology. Drug treatments Proctology Radiation Radiotherapy, Adjuvant Rectal Neoplasms - drug therapy Rectal Neoplasms - radiotherapy Rectal Neoplasms - surgery Stomach. Duodenum. Small intestine. Colon. Rectum. Anus Surgery Surgical Wound Dehiscence - etiology Surgical Wound Infection - etiology Treatment Outcome Tumors Young Adult |
| title | Laparoscopic versus open surgery for rectal cancer after neoadjuvant chemoradiation: a matched case-control study of short-term outcomes |
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