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Minimally invasive versus open total mesorectal excision for rectal cancer: Long-term results from a case-matched study of 633 patients

Authors
 Min Soo Cho  ;  Chang Woo Kim  ;  Se Jin Baek  ;  Hyuk Hur  ;  Byung Soh Min  ;  Seung Hyuk Baik  ;  Kang Young Lee  ;  Nam Kyu Kim 
Citation
 SURGERY, Vol.157(6) : 1121-1129, 2015 
Journal Title
 SURGERY 
ISSN
 0039-6060 
Issue Date
2015
MeSH
Adenocarcinoma/mortality ; Adenocarcinoma/pathology ; Adenocarcinoma/surgery* ; Aged ; Case-Control Studies ; Colectomy/methods* ; Colectomy/mortality ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Minimally Invasive Surgical Procedures/mortality ; Multivariate Analysis ; Neoplasm Recurrence, Local/mortality ; Neoplasm Recurrence, Local/pathology* ; Proctoscopy/methods* ; Proctoscopy/mortality ; Rectal Neoplasms/mortality ; Rectal Neoplasms/pathology ; Rectal Neoplasms/surgery* ; Republic of Korea ; Retrospective Studies ; Risk Assessment ; Robotic Surgical Procedures/methods* ; Robotic Surgical Procedures/mortality ; Survival Analysis ; Time Factors ; Treatment Outcome
Abstract
BACKGROUND: This study compared the long-term oncologic outcomes of patients with rectal cancer who underwent either laparoscopic or robotic total mesorectal excision (TME) via minimally invasive surgery (MIS) to those patient who underwent open TME. METHODS: This study was a retrospective, case-control study; patients in the 2 groups were matched according to age, sex, MIS vs open operation, body mass index, tumor location, pathologic TNM stage (ie, tumor-node-metastasis), neoadjuvant treatment, and adjuvant treatment. RESULTS: A total of 633 patients (MIS, n = 211; open, n = 422) were assessed. The median follow-up period was 64 (2-124) months. Patient characteristics did not differ between the groups. Overall postoperative complication rates did not differ between the groups (16.0% [MIS]; 17.0% [open]; P = .76). Rates of the involvement of the circumferential resection margin did not differ between the groups (4.0% [MIS]; 5.0% [open]; P = .84). The 5-year overall survival, disease-specific survival, disease-free survival, and local recurrence rates were not different between the MIS and open groups (overall survival = 88.4% vs 85.3%, P = .23; disease-specific survival = 88.8% vs 87.4%, P = .53, disease-free survival = 80.7% vs 78.4%, P = .74; local recurrence = 5.7% vs 5.1%, P = .95). In subgroup analysis, no differences were found in terms of the long-term, oncologic outcomes, oncologic adequacy, and postoperative complications among 3 groups. CONCLUSION: We found no differences in the oncologic outcomes between MIS and open surgery, suggesting that MIS for rectal cancer is a safe option for rectal cancer that does not increase the risk of serious complications.
Full Text
http://www.sciencedirect.com/science/article/pii/S0039606015000264
DOI
10.1016/j.surg.2015.01.010
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Lee, Kang Young(이강영)
Cho, Min Soo(조민수)
Hur, Hyuk(허혁) ORCID logo https://orcid.org/0000-0002-9864-7229
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156850
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