Does the Neoadjuvant Chemoradiotherapy Increase Postoperative Complications in Laparoscopic Low Anterior Resection?

Alejandro G Canelas, MD, Maximiliano E Bun, MD, Esteban E Grzona, MD, Mariano Laporte, MD, Federico Carballo, MD, Nicolás A Rotholtz, MD. Hospital Alemán, Buenos Aires, Argentina


Neoadjuvant radiation and chemoradiotherapy in rectal cancer reduces local recurrence. However, many authors report an increase in the rate of intraoperative and postoperative complications due to local effects generated by the radiation. The aim of this study is to assess whether these preoperative treatment increases the rate of morbidity in patients undergoing laparoscopic low anterior resection.

A retrospective study was performed using a prospective collected database. All patients with rectal cancer who underwent laparoscopic low anterior resection between July 2003 and July 2011 were included. Patients who underwent total proctocolectomy or abdominoperineal resection were excluded. The series was divided into two groups; G1: patients who were operated after diagnosis, and G2: patients who underwent preoperative chemoradiation. Preoperative data and perioperative morbidity were compared between groups by univariate analysis.

66 patients with rectal cancer were included; G1: 50 (76%) y G2: 16 (24%). Preoperative data was homogeneous between the two groups, but G2 presented more advanced stages.
G2 had longer surgical time (G1: 227 +/- 70 vs. G2: 301 +/- 97 minutes; p < 0.05), but there were no differences in the rate of intraoperative complications and in the conversion rate.
There were no differences in the rate of postoperative complications, return to bowel function and postoperative length of stay.

Preoperative neoadjuvant chemoradiotherapy in patients with rectal cancer undergoing laparoscopic low anterior resection does not increase intraoperative and postoperative complications. However it increases operating times.


Session Number: Poster – Poster Presentations
Program Number: P047
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