Javier Ernesto Barreras González, PhD, MD, Miguel Ángel Martínez Alfonso, PhD, MD, Rafael Torres Peña, PhD, MD, Jorge Gerardo Pereira, MD, Francisco Llorente Llano, MD, Juan Bautista Olivé González, MD. National Center for Minimally Invasive Surgery Havana. Cuba
Introduction: This study reports the long-term results for a prospective rectal cancer management program using laparoscopic low anterior resection (LAR), abdominoperineal resection (APR), transanal endoscopic microsurgery (TEM) and laparoscopic radical transanal abdominal transanal proctosigmoidectomy with coloanal anastomosis (TATA).
Methods and procedures: A prospective study was on 287 consecutive patients with rectal cancer between January 2005 and December 2015 in a tertiary referral university-affiliated center specializing in endoscopic and laparoscopic surgery. All resections were carried out by a team of dedicated colorectal surgeons and standard protocol was used for all pre-and-post-operative care. We were waited 8-12 weeks from the completion of neoadjuvant treatment until surgery to allow for the maximal downstaging effect of chemoradiation. All the patients underwent total mesorectal excision in laparoscopic group.
Results: There were 106 patients in the TEM group. The overall incidence of morbidity was 5,6% (6/106). Mean follow-up was 58 (3-120) months with a recurrence rate of 0% in pTis, 5,8% in pT1, 8,1% in pT2 and 7,7% in pT3. Overall estimated 5-year survival was 95,7% and the disease-free survival rate was 93,7%. Of the 181 patients in the laparoscopic group, 129 underwent LAR, 30 APR and 22 TATA. The major morbidity rate was 14% in LAR, 11% in APR and 13,6% in TATA. Overall estimated 5-year survival was 81,8%.
Conclusion: Minimally invasive rectal surgery can be safely undertaken for a wide variety of procedures with a high expectation of success.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80353
Program Number: P259
Presentation Session: Poster (Non CME)
Presentation Type: Poster
