Reconsideration of the Safety of Laparoscopic Rectal Surgery for Cancer
Annals of Coloproctology
;
: 229-237, 2019.
Artículo
en Inglés
| WPRIM
| ID: wpr-762334
ABSTRACT
The oncological outcomes of laparoscopic rectal cancer surgery were evaluated in recent multicenter randomized clinical trials (RCTs). The MRC-CLASSIC, COLOR II, and COREAN trials found no differences in local recurrence or disease-free survival rate between laparoscopic and open surgery. However, the noninferiority of laparoscopic surgery with respect to open surgery for rectal cancer was not established on statistical analysis in the ACOSOG Z6051 and the ALaCaRT trials. Quality of total mesorectal excision (TME) is one of the most important prognostic factors. Incomplete TME had unfavorable oncologic outcomes compared to complete TME. Although TME quality can be clearly identified on pathologic evaluation, there is controversy regarding the acceptable range of oncologically safe TME for laparoscopic surgery. It is not certain whether near-complete TME has an unfavorable oncologic impact and whether laparoscopic surgery with near-complete TME is an oncological threat. Therefore, the surgical community will be interested in the long-term outcomes and meta-analyses of ongoing large-scale RCTs. Laparoscopic rectal cancer surgery has been steadily improving its safety for oncology surgery, which has been reported consistently in various multicenter RCTs. To improve surgical quality, colorectal surgeons should choose the most appropriate surgical technique, including laparoscopic surgery.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Control de Calidad
/
Neoplasias del Recto
/
Recurrencia
/
Resultado del Tratamiento
/
Laparoscopía
/
Supervivencia sin Enfermedad
/
Cirujanos
Tipo de estudio:
Ensayo Clínico Controlado
/
Estudio pronóstico
Idioma:
Inglés
Revista:
Annals of Coloproctology
Año:
2019
Tipo del documento:
Artículo
Similares
MEDLINE
...
LILACS
LIS