Preview

Koloproktologia

Advanced search

LATE RESULTS OF TOTAL MESORECTUMECTOMY IN RECTAL CANCER AFTER OPEN AND LAPAROSCOPIC PROCEDURES

https://doi.org/10.33878/2073-7556-2019-18-3-41-48

Abstract

AIM: to evaluate late results for patients that had open and laparoscopic total mesorectumectomy (TME) surgery for rectal cancer. PATIENTS AND METHODS: prospective cohort study included 103 patients aged from 20 to 70 years with rectal cancer. Patients were divided into 2 groups: the 1st group included 47 patients after laparoscopic TME (LTME) and the 2nd group included 56 patients after open one (OTME). All tumors were adenocarcinomas. Late results were assessed by actual and disease-free 3- and 5-year survival in 97 (94.2%) patients. RESULTS: local recurrence rate after OTME and LTME was 11,5% (6 patients) and 11,1% (5 patients) (p>0.05). Distant metastases occurred in 4 (7,7%) and 3 (6,7%) cases, respectively (p>0.05). The actual survival after LTME was 80.0% (81.8% after OTME, p>0.05), the disease-free 3-year survival rate was 56,7% (60.6% after OTME, p>0.05), 5-year survival was 31.6% (31.8% after OTME, p>0.05). CONCLUSION: no significant differences were found between laparoscopic and open approach for rectal cancer in local recurrence rate and survival.

About the Authors

E. G. Azimov
Azerbaijan Medical University, clinic «ELMED»
Russian Federation
Department of Surgical Diseases № 1


S. A. Aliyev
Azerbaijan Medical University, clinic «ELMED»
Russian Federation
Department of Surgical Diseases № 1


References

1. Zaharenko A.A., Belyaev M.A., Morozov A.N. et al. Prediction of risk factors of lateral lymph node metastasis in rectal cancer. Vestn. hir. 2015; v. 174, no. 4, pр. 30-33. (in Russ.)

2. Ferlay J, Sverjomataram Y, Dikshit R et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int. J. Cancer. 2015;1:359-386.

3. Tulina L.A., Zhukovskij V.I., Bredihin M.I. et al. Selective approach for splenic flexure mobilization in total mezorectal excision followed by low colorectal anastomoses. Hirurgiya. 2018; no. 7, pр. 41-46. (in Russ.)

4. Khvatov A.A., Maystrenko N.A., Sazonov A.A., Sherstnova E.M. et al. The posibilities of surgical treatment of patients with recurrences of rectal cancer. Vest.hir. 2018; v.177, no. 2, pр. 39-45. (in Russ.)

5. Kalyan A., Rozelle S. Neoadjuvant treatment of rectal cancer: where are we now? Gastroenterol Rep (Oxf). 2016; 4(3):206-209. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4976683.

6. Habr-Gama A, Perez RO, Sabbaga L. et al. Increasing the rates of complete response to neoadjuvant chemordiotherapy for distal rectal canser: results of a prospective study using additional chemotherapy during the resting period. Dis Colon Rectum. 2009;52(12):1927-1934.

7. Habr-Gama A, Perez RO, Proscurshin I. et al. Interval between surgery and neoadjuvant chemoradiation therapy for distal rectal cancer; does delayed surgery have an impact on outcome? Jut. J. Radiat Oncol Biol. Phys. 2008; 71(4):1181-1188.

8. Wong RK, Berry S, Spithoff et al. Preoperative or postoperative therapy for stage or III rectal cancer: an updated practice guideline. Clin. Oncol. 2010;22:265-271. https://www.ncbi.nlm.nih.gov/ pubmed/20398849.

9. Julian LA, Thorson AG. Current neoadjuvant strategies in rectal cancer. Surg. Oncol. 2010, P. 321-326.

10. Kapiteijn E., Marijnen C.A., Nagtegaal I.D. et al. Preoperative radiotherapy combined with total mesorectal excision for resectable rectal cancer. N. Engl. J. Med. 2001;345:638-646.

11. Schrag D. Evolving role of neoadjuvant therapy in rectal cancer. Curr Treat Options Oncol. 2013;14(3):350-364. https://www. ncbi.nlm.nih. gov/ pubmed/23828092.

12. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery – the clue to pelvic recurrence? Br. J. Surg. 1982; 69(10): 613-6.

13. Heald RJ, Moran BJ, Ryall RD et al. Rectal cancer: the Basingstoke experience of total mesorectal excision, 1978-1997. Arch. Surg. 1998; 133(8):894-899.

14. Quirke P. Training and quality assurance for rectal cancer: 20 years of data is enough. Lancet Oncol. 2003;4(11): 695-702.

15. Leestraten EC, Kuppen PJ, van de Velde CJ. Marijen CA. Prediction in rectal cancer. Semin. Radiat. Oncol. 2012; 22(2):175-183.

16. Mac-Farlane JK, Ryall RdH., Heald RJ. Mesorectal excision for rectal cancer. The Lancet. 1993;341(8843):457-460.

17. Quirke P, Durdey P, Dixon M. Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Histopathological study of lateral tuman sprcad and surgical excision. Lancet. 1986;2:996-999. https://link.springer.com/article/10.1007/ BF01645318.

18. Vennix S, Pelzers L, Bouvy N. Laparoscopic versus open total mesorectal excision for rectal cancer. Cochrane Database Syst Rev. 2014; 4: 301-304.

19. Petrova E.A. Laparoscopic total mezorectumectomy in patients with cancer of the mid- and upper ampular rectum. Assessment of safety and oncological adequacy. Thesis for PhD degree, St. Petersburg, 2017, 22 p. (in Russ.)

20. Rasulov A.O., Mamedli Z.Z., Dzhumabaev Kh.E., Kulushev V.M. et al. Total mesorectal excision in rectal cancer management: laparoscopic or transanal? Surgery. 2016; no. 5, pp. 37-44 (in Russ.)

21. Khubezov D.A., Puchkov K.V., Puchkov D.K., Ogoreltsov A.Yu. et al. Laparoscopic total mezorectectomy (literature review). Koloproktologia. 2016; no. 4(58), pp. 87-93 (in Russ.)

22. Nagtegaal ID, van de Velde CJ, van der Worp E. et al. Macroscopic evaluation of rectal cancer resection specimen: clinical significance of the pathologist in quality control. J. Clin. Oncol. 2002; 20(7): 1729-1734.

23. Quirke P, Williams GT. Minimum dataset for colorectal cancer histopathology reports. London: The Royal College of Pathologists 2000. (www.Repart.org).

24. Bonjer HJ, Deijen CL, Abis GA et al. Randomized trial of laparoscopic versus open surgery for rectal cancer. Surg. Endosc. 2015;29(2): 334-348.

25. Kennedy RH, Francis EA, Wharton R. et al. Multicenter randomized controlled trial of conventional versus laparoscopic surgery for colorectal cancer within an Enhanced Recovery Programme: EnROL. J. Clin. Oncol. 2014;32(17): 1804-1811.

26. Stevenson AR, Solomon MJ, Lumley JW et al. Effect of laparoscopic-assisted resection vs open resection on pathological outcomes in rectal cancer: the AlaCaRT randomized clinical trial. JAMA. 2015; 314(13): 1356-1363.

27. Shelygin Yu.A., Chernyshov S., Kazieva L., Maynovskaya O. et al. Сomparative analysis of open and transanal total mesorectal excision at rectal cancer. Koloproktologia. 2018; no. 4(66), pp. 69-75 (in Russ.)


Review

For citations:


Azimov E.G., Aliyev S.A. LATE RESULTS OF TOTAL MESORECTUMECTOMY IN RECTAL CANCER AFTER OPEN AND LAPAROSCOPIC PROCEDURES. Koloproktologia. 2019;18(3(69)):41-48. (In Russ.) https://doi.org/10.33878/2073-7556-2019-18-3-41-48

Views: 691


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2073-7556 (Print)
ISSN 2686-7303 (Online)