Yu-Chun Huang, YI-Chang Chen, Yuan-Yao Tsai, Sheng-Chi Chang, Tao-Wei Ke, Hung-Change Chen, Hwei-ming Wang, William Tzu-Liang Chen. Department of Colorectal Surgery, China Medical University Hospital, Taichung, Taiwan
Objective: To examine survival of patients who underwent minimally inva- sive low anterior resection (LAR) versus open LAR for rectal cancer in single medical center in Taiwan.
Background: The utilization of minimally invasive surgery (including of laparoscopic and robotic LAR) for rectal cancer has steadily increased. Short-term outcomes between these techniques and open surgery have shown equivalent results. However, long-term survival outcomes between these groups are unknown.
Methods: We retrospectively enrolled 613 patients who suffered from the rectal cancer and underwent LAR in China Medical University Hospital from January 2012 from December 2016. Patients were classified as laparoscopic, robotic, and open groups. The clinicopathological and surgical data of these patients were collected and retrospectively analyzed.
Results: Among 613 patients with rectal cancer, 93.8% minimally invasive LAR (MI-LAR) and 6.2% underwent open LAR (O-LAR) and. Among 613 patients, 95% of the patients underwent sphincter-preserving operation. Overall, 5-year overall survival rate was 80.6% and 5-year disease-free survival rate was 75.3%. Local recurrence occurred in 4.23% of the patients and distant metastases occurred in 23.9% of the patients. MI-LAR was associated with shorter length of stay, shorter days of urinary catheterization, less circumferential resection margin, less 30-day mortality, but equivalent distal resection margin. In a subgroup analysis of laparoscopic LAR (L-LAR) versus robotic LAR (R-LAR), there were no differences in lymph node harvest, distal and circumferential margin positivity, length of stay. The 3-year and 5-year overall survival for MI-LAR were 86.6% and 80.5%. The 3-year and 5-year overall survival for O-LAR were 81.1%. The 3-year and 5-year disease-free survival for MI-LAR were 79.6% and 75.6%. The 3-year and 5-year disease-free survival for O-LAR were 69.3%.
Conclusions: In our retrospective study, minimally invasive LAR for rectal cancer has better short-term and long-term outcome than open LAR. Our findings support the ongoing adoption of minimally invasive techniques for rectal cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87475
Program Number: P268
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster