Journal ArticleDOI
Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial.
Seung-Yong Jeong,Seung-Yong Jeong,Ji Won Park,Ji Won Park,Byung-Ho Nam,Sohee Kim,Sung Bum Kang,Seok Byung Lim,Hyo Seong Choi,Duck Woo Kim,Hee Jin Chang,Dae Yong Kim,Kyung Hae Jung,Tae You Kim,Gyeong Hoon Kang,Eui Kyu Chie,Sun-Young Kim,Dae Kyung Sohn,Dae-Hyun Kim,Jae Sung Kim,Hye Seung Lee,Jee Hyun Kim,Jae Hwan Oh +22 more
TLDR
The results show that laparoscopic resection for locally advanced rectal cancer after preoperative chemoradiotherapy provides similar outcomes for disease-free survival as open resection, thus justifying its use.Abstract:
Summary Background Compared with open resection, laparoscopic resection of rectal cancers is associated with improved short-term outcomes, but high-level evidence showing similar long-term outcomes is scarce. We aimed to compare survival outcomes of laparoscopic surgery with open surgery for patients with mid-rectal or low-rectal cancer. Methods The Comparison of Open versus laparoscopic surgery for mid or low REctal cancer After Neoadjuvant chemoradiotherapy (COREAN) trial was an open-label, non-inferiority, randomised controlled trial done between April 4, 2006, and Aug 26, 2009, at three centres in Korea. Patients (aged 18–80 years) with cT3N0–2M0 mid-rectal or low-rectal cancer who had received preoperative chemoradiotherapy were randomly assigned (1:1) to receive either open or laparoscopic surgery. Randomisation was stratified by sex and preoperative chemotherapy regimen. Investigators were masked to the randomisation sequence; patients and clinicians were not masked to the treatment assignments. The primary endpoint was 3 year disease-free survival, with a non-inferiority margin of 15%. Analysis was by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00470951. Findings We randomly assigned 340 patients to receive either open surgery (n=170) or laparoscopic surgery (n=170). 3 year disease-free survival was 72·5% (95% CI 65·0–78·6) for the open surgery group and 79·2% (72·3–84·6) for the laparoscopic surgery group, with a difference that was lower than the prespecified non-inferiority margin (–6·7%, 95% CI −15·8 to 2·4; p Interpretation Our results show that laparoscopic resection for locally advanced rectal cancer after preoperative chemoradiotherapy provides similar outcomes for disease-free survival as open resection, thus justifying its use. Funding National Cancer Center, South Korea.read more
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Evaluation of the intestinal blood flow near the rectosigmoid junction using the indocyanine green fluorescence method in a colorectal cancer surgery
Jun Watanabe,Mitsuyoshi Ota,Yusuke Suwa,Shinsuke Suzuki,Hirokazu Suwa,Masasi Momiyama,Atsushi Ishibe,Kazuteru Watanabe,Hidenobu Masui,Kaoru Nagahori,Yasushi Ichikawa,Itaru Endo +11 more
TL;DR: This study proves that cases without the anastomosis of the marginal artery of the rectosigmoid junction truly exist, using studies in living humans (UMIN000011186).
Journal ArticleDOI
Transanal Total Mesorectal Excision vs Laparoscopic Total Mesorectal Excision in the Treatment of Low and Middle Rectal Cancer: A Propensity Score Matching Analysis.
Roberto Persiani,Alberto Biondi,Francesco Pennestrì,Valeria Fico,Veronica De Simone,Flavio Tirelli,Francesco Santullo,Domenico D'Ugo +7 more
TL;DR: Transanal total mesorectal excision is a safe and feasible technique that results in a high-quality rectal cancer resection specimen and favorable 30-day postoperative outcomes.
Journal ArticleDOI
Robot-assisted versus laparoscopic surgery for lower rectal cancer: the impact of visceral obesity on surgical outcomes.
TL;DR: It is demonstrated that RALS has some advantages in terms of surgical outcomes over CLS in challenging situations ofrectal cancer surgery, such as lower rectal cancer cases and visceral obesity cases.
Journal ArticleDOI
Natural Orifice Specimen Extraction With Single Stapling Colorectal Anastomosis for Laparoscopic Anterior Resection: Feasibility, Outcomes, and Technical Considerations.
Bansal Saurabh,Sheng-Chi Chang,Tao-Wei Ke,Yu-Chun Huang,Takashi Kato,Hwei-Ming Wang,William Tzu-Liang Chen,Abe Fingerhut +7 more
TL;DR: Anatomic variations (short colon and short mesentery) can be managed adequately with intracorporeal anvil head fixation and the single stapling technique is feasible and as safe as conventional double staplings techniques, although it is technically more demanding.
Journal ArticleDOI
Long-term oncological outcomes of robotic versus laparoscopic total mesorectal excision of mid–low rectal cancer following neoadjuvant chemoradiation therapy
Dae Ro Lim,Sung Uk Bae,Sung Uk Bae,Hyuk Hur,Byung Soh Min,Seung Hyuk Baik,Kang Young Lee,Nam Kyu Kim +7 more
TL;DR: Robotic surgery for rectal cancer after neoadjuvant CRT can be performed safely, with long-term oncological outcomes comparable to those obtained with laparoscopic surgery, according to prospective follow-up data.
References
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Preoperative versus Postoperative Chemoradiotherapy for Rectal Cancer
Rolf Sauer,Heinz Becker,Werner Hohenberger,Claus Rödel,Christian Wittekind,Rainer Fietkau,Peter Martus,Jörg Tschmelitsch,Eva Hager,Clemens F. Hess,Torsten Liersch,Heinz Schmidberger,Rudolf Raab +12 more
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A comparison of laparoscopically assisted and open colectomy for colon cancer.
Heidi Nelson,Daniel J. Sargent,H Sam Wieand,James W. Fleshman,Mehran Anvari,Steven J. Stryker,Robert W. Beart,Michael D. Hellinger,Richard Flanagan,Walter R. Peters,David M. Ota +10 more
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Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial
Pierre J. Guillou,Philip Quirke,H. Thorpe,J. Walker,David G. Jayne,Adrian Smith,Richard M. Heath,Julia Brown +7 more
TL;DR: Laroscopic-assisted surgery for cancer of the colon is as effective as open surgery in the short term and is likely to produce similar long-term outcomes, however, impaired short- term outcomes after laparosc-assisted anterior resection forcancer of the rectum do not yet justify its routine use.
Journal ArticleDOI
Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial
Antonio M. Lacy,Juan Carlos García-Valdecasas,Salvadora Delgado,Antoni Castells,Pilar Taura,Josep M. Piqué,Josep Visa +6 more
TL;DR: LAC is more effective than OC for treatment of colon cancer in terms of morbidity, hospital stay, tumour recurrence, and cancer-related survival.
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Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group.
David G. Jayne,Pierre J. Guillou,H. Thorpe,Philip Quirke,Joanne Copeland,Adrian Smith,Richard M. Heath,Julia Brown +7 more
TL;DR: Long-term outcomes for patients with rectal cancer were similar in those undergoing abdominoperineal resection and AR, and support the continued use of laparoscopic surgery in these patients.