Standardised approach to laparoscopic total mesorectal excision for rectal cancer: a prospective multi-centre analysis

Langenbeck's Archives of Surgery
Marc BullockAmjad Parvaiz

Abstract

Two non-inferiority randomised control trials have questioned the utility of laparoscopic surgery for rectal cancer by failing to prove that pathological markers of high-quality surgery are equivalent to those achieved by open technique. We present short- and long-term post-operative outcomes from the largest single surgeon series of consecutive patients undergoing laparoscopic TME for rectal cancer. We describe the standardised laparoscopic technique developed by the principal surgeon, and the short-term outcomes from three surgeons who were trained in and subsequently adopted the same approach. Prospectively acquired data from consecutive patients undergoing surgery for rectal cancer by the principal surgeon at the minimally invasive colorectal unit in Portsmouth between 2006 and 2014 were analysed along with data acquired between 2010 and 2017 from surgeons at three further international centres. Endpoints were overall and disease-free survival at 5 years, and early post-operative clinical and pathological outcomes. Two hundred sixty-three consecutive patients underwent laparoscopic TME surgery by the principal surgeon. At 5 years, overall survival was 82.9% (Dukes' A = 94.4%; B = 81.6%; C = 73.7%); disease-free survival was...Continue Reading

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Citations

Feb 11, 2020·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·Shenghui HuangPan Chi
May 31, 2020·Langenbeck's Archives of Surgery·Sofoklis PanteleimonitisAmjad Parvaiz
Nov 23, 2020·Langenbeck's Archives of Surgery·Hironori FukuokaMasashi Ueno
Dec 4, 2020·World Journal of Gastroenterology : WJG·Fang-Ze WeiQian Liu
Mar 7, 2021·Updates in Surgery·Irfan NasirAmjad Parvaiz

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