Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma

Seiichiro Yamamoto, Masahiko Watanabe, Hirotoshi Hasegawa, Masaki Kitajima

Research output: Contribution to journalArticle

62 Citations (Scopus)

Abstract

PURPOSE: This study was designed to examine the shortterm results of laparoscopy in the treatment of curative cases of rectosigmoidal and rectal carcinoma. METHODS: A review was performed of a prospective registry of 70 patients who underwent curative laparoscopic resection for rectosigmoidal and rectal carcinoma between July 1993 and April 2001. Before 1997, only patients with early (Tis or TI) cancers located in the rectosigmoid and upper rectum that required bowel resection were candidates for laparoscopy. In 1997, we expanded the application of laparoscopy to include T2 cancers located anywhere in the rectum. Mesorectal transection was performed at least 5 cm below the tumor for rectosigmoidal and upper rectal lesions, and total mesorectal excision was performed for lower tumors. Primary anastomosis was performed by a double-stapling technique, or a per anum handsewn coloanal anastomosis was performed. Patient demographics and outcomes were recorded prospectively. RESULTS: The median follow-up was 23 months. An anastomosis was performed in 92.9 percent of the operations. Oral intake was started on median postoperative Day 1, and the median length of hospitalization was 8 days. Two patients needed conversion to conventional open surgery. A total of 15 postoperative complications occurred in 13 patients (18.6 percent), including anastomotic leakage in 6 (8.6 percent) and bowel obstruction in 3 (4.3 percent). Reoperation was required in six patients. Two patients developed recurrence of cancer at the anastomotic site. The expected 5-year survival and disease-free survival rates were 100 and 92.1 percent, respectively. CONCLUSION: The findings of the present study demonstrate the feasibility and safety of laparoscopic surgery for selected patients with rectal carcinoma. Morbidity and mortality rates and oncologic outcome appear to be comparable with conventional surgery.

Original languageEnglish
Pages (from-to)1648-1654
Number of pages7
JournalDiseases of the Colon and Rectum
Volume45
Issue number12
DOIs
Publication statusPublished - 2002 Dec 1

Fingerprint

Laparoscopy
Carcinoma
Neoplasms
Rectum
Conversion to Open Surgery
Anastomotic Leak
Feasibility Studies
Reoperation
Disease-Free Survival
Registries
Hospitalization
Survival Rate
Demography
Morbidity
Safety
Recurrence
Survival
Mortality

Keywords

  • Laparoscopic resection
  • Laparoscopic surgery
  • Rectal carcinoma

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. / Yamamoto, Seiichiro; Watanabe, Masahiko; Hasegawa, Hirotoshi; Kitajima, Masaki.

In: Diseases of the Colon and Rectum, Vol. 45, No. 12, 01.12.2002, p. 1648-1654.

Research output: Contribution to journalArticle

Yamamoto, Seiichiro ; Watanabe, Masahiko ; Hasegawa, Hirotoshi ; Kitajima, Masaki. / Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. In: Diseases of the Colon and Rectum. 2002 ; Vol. 45, No. 12. pp. 1648-1654.
@article{c17d01905fb54e30a57d69cb06dbcf51,
title = "Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma",
abstract = "PURPOSE: This study was designed to examine the shortterm results of laparoscopy in the treatment of curative cases of rectosigmoidal and rectal carcinoma. METHODS: A review was performed of a prospective registry of 70 patients who underwent curative laparoscopic resection for rectosigmoidal and rectal carcinoma between July 1993 and April 2001. Before 1997, only patients with early (Tis or TI) cancers located in the rectosigmoid and upper rectum that required bowel resection were candidates for laparoscopy. In 1997, we expanded the application of laparoscopy to include T2 cancers located anywhere in the rectum. Mesorectal transection was performed at least 5 cm below the tumor for rectosigmoidal and upper rectal lesions, and total mesorectal excision was performed for lower tumors. Primary anastomosis was performed by a double-stapling technique, or a per anum handsewn coloanal anastomosis was performed. Patient demographics and outcomes were recorded prospectively. RESULTS: The median follow-up was 23 months. An anastomosis was performed in 92.9 percent of the operations. Oral intake was started on median postoperative Day 1, and the median length of hospitalization was 8 days. Two patients needed conversion to conventional open surgery. A total of 15 postoperative complications occurred in 13 patients (18.6 percent), including anastomotic leakage in 6 (8.6 percent) and bowel obstruction in 3 (4.3 percent). Reoperation was required in six patients. Two patients developed recurrence of cancer at the anastomotic site. The expected 5-year survival and disease-free survival rates were 100 and 92.1 percent, respectively. CONCLUSION: The findings of the present study demonstrate the feasibility and safety of laparoscopic surgery for selected patients with rectal carcinoma. Morbidity and mortality rates and oncologic outcome appear to be comparable with conventional surgery.",
keywords = "Laparoscopic resection, Laparoscopic surgery, Rectal carcinoma",
author = "Seiichiro Yamamoto and Masahiko Watanabe and Hirotoshi Hasegawa and Masaki Kitajima",
year = "2002",
month = "12",
day = "1",
doi = "10.1007/s10350-004-7253-2",
language = "English",
volume = "45",
pages = "1648--1654",
journal = "Diseases of the Colon and Rectum",
issn = "0012-3706",
publisher = "Lippincott Williams and Wilkins",
number = "12",

}

TY - JOUR

T1 - Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma

AU - Yamamoto, Seiichiro

AU - Watanabe, Masahiko

AU - Hasegawa, Hirotoshi

AU - Kitajima, Masaki

PY - 2002/12/1

Y1 - 2002/12/1

N2 - PURPOSE: This study was designed to examine the shortterm results of laparoscopy in the treatment of curative cases of rectosigmoidal and rectal carcinoma. METHODS: A review was performed of a prospective registry of 70 patients who underwent curative laparoscopic resection for rectosigmoidal and rectal carcinoma between July 1993 and April 2001. Before 1997, only patients with early (Tis or TI) cancers located in the rectosigmoid and upper rectum that required bowel resection were candidates for laparoscopy. In 1997, we expanded the application of laparoscopy to include T2 cancers located anywhere in the rectum. Mesorectal transection was performed at least 5 cm below the tumor for rectosigmoidal and upper rectal lesions, and total mesorectal excision was performed for lower tumors. Primary anastomosis was performed by a double-stapling technique, or a per anum handsewn coloanal anastomosis was performed. Patient demographics and outcomes were recorded prospectively. RESULTS: The median follow-up was 23 months. An anastomosis was performed in 92.9 percent of the operations. Oral intake was started on median postoperative Day 1, and the median length of hospitalization was 8 days. Two patients needed conversion to conventional open surgery. A total of 15 postoperative complications occurred in 13 patients (18.6 percent), including anastomotic leakage in 6 (8.6 percent) and bowel obstruction in 3 (4.3 percent). Reoperation was required in six patients. Two patients developed recurrence of cancer at the anastomotic site. The expected 5-year survival and disease-free survival rates were 100 and 92.1 percent, respectively. CONCLUSION: The findings of the present study demonstrate the feasibility and safety of laparoscopic surgery for selected patients with rectal carcinoma. Morbidity and mortality rates and oncologic outcome appear to be comparable with conventional surgery.

AB - PURPOSE: This study was designed to examine the shortterm results of laparoscopy in the treatment of curative cases of rectosigmoidal and rectal carcinoma. METHODS: A review was performed of a prospective registry of 70 patients who underwent curative laparoscopic resection for rectosigmoidal and rectal carcinoma between July 1993 and April 2001. Before 1997, only patients with early (Tis or TI) cancers located in the rectosigmoid and upper rectum that required bowel resection were candidates for laparoscopy. In 1997, we expanded the application of laparoscopy to include T2 cancers located anywhere in the rectum. Mesorectal transection was performed at least 5 cm below the tumor for rectosigmoidal and upper rectal lesions, and total mesorectal excision was performed for lower tumors. Primary anastomosis was performed by a double-stapling technique, or a per anum handsewn coloanal anastomosis was performed. Patient demographics and outcomes were recorded prospectively. RESULTS: The median follow-up was 23 months. An anastomosis was performed in 92.9 percent of the operations. Oral intake was started on median postoperative Day 1, and the median length of hospitalization was 8 days. Two patients needed conversion to conventional open surgery. A total of 15 postoperative complications occurred in 13 patients (18.6 percent), including anastomotic leakage in 6 (8.6 percent) and bowel obstruction in 3 (4.3 percent). Reoperation was required in six patients. Two patients developed recurrence of cancer at the anastomotic site. The expected 5-year survival and disease-free survival rates were 100 and 92.1 percent, respectively. CONCLUSION: The findings of the present study demonstrate the feasibility and safety of laparoscopic surgery for selected patients with rectal carcinoma. Morbidity and mortality rates and oncologic outcome appear to be comparable with conventional surgery.

KW - Laparoscopic resection

KW - Laparoscopic surgery

KW - Rectal carcinoma

UR - http://www.scopus.com/inward/record.url?scp=0036904795&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0036904795&partnerID=8YFLogxK

U2 - 10.1007/s10350-004-7253-2

DO - 10.1007/s10350-004-7253-2

M3 - Article

VL - 45

SP - 1648

EP - 1654

JO - Diseases of the Colon and Rectum

JF - Diseases of the Colon and Rectum

SN - 0012-3706

IS - 12

ER -