Authors: Nicola de’Angelis Filippo Landi Giulio Cesare Vitali Riccardo Memeo Aleix MartínezPérez Alejandro Solis Michela Assalino Francesc Vallribera Henry Alexis Mercoli Jacques Marescaux Didier Mutter Frédéric Ris Eloy Espin Francesco Brunetti
Publish Date: 2016/11/08
Volume: 31, Issue: 8, Pages: 3106-3121
Abstract
In total 137 patients were included in the analysis After PSM demographic clinical and tumor characteristics were similar between the 52 LAR and the 52 OAR patients Overall 52 tumors were located in the high rectum 25 in the midrectum and 27 in the low rectum Multivisceral resection was performed in 269 of LAR and 308 of OAR patients p = 0829 Conversion was required in 11 LAR patients 212 The LAR group showed significantly shorter time to flatus 313 vs 497 days p = 0001 time to regular diet 359 vs 636 days p 00001 and hospital stay 1549 vs 1796 days p = 0002 compared to the OAR group The 90day morbidity and mortality were not different between groups In the majority of patients 856 R0 resection was achieved A complete mesorectal excision was obtained in 827 of LAR and 788 of OAR patients p = 0855 The 1 2 and 3year overall survival rates were respectively 956 738 and 667 for the LAR group and 867 669 and 641 for the OAR group p = 0219 The presence of synchronous metastases hazard ratio 226 R1 resection HR 271 and lymph node involvement HR 224 were significant predictors of overall survivalThe present study suggests that LAR for pT4 rectal cancer can achieve good pathologic and oncologic outcomes similar to open surgery despite the risk of conversion Moreover laparoscopy offers the benefits of a faster recovery and a shorter hospital stayNicola de’Angelis Filippo Landi Giulio Cesare Vitali Riccardo Memeo Aleix MartínezPérez Alejandro Solis Michela Assalino Francesc Vallribera Henry Alexis Mercoli Jacques Marescaux Didier Mutter Frédéric Ris Eloy Espin and Francesco Brunetti have no conflicts of interest to disclose with regard to the results of this study
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