ABSTRACT
BACKGROUND: Lateral pelvic lymph node dissection (LPLD) in rectal cancer has been carried out in several major centers. However, there are still many controversial issues regarding this method such as feasibility, safety, and oncological outcome. OBJECTIVE: The aim of this study was to evaluate the short-term outcomes, safety, and feasibility of LPLD. METHODS: This was a retrospective study. A total of 117 patients with lower rectal cancer (clinical stage II/III) below the peritoneal reflection underwent surgery between January 2019 and November 2020 at 108 Military Central Hospital, Hanoi, Vietnam. RESULTS: Total amount of 25 patients underwent laparoscopic total mesorectal excision (TME) plus LPLD and 92 patients underwent laparoscopic TME without LPLD. The rate of lateral pelvic lymph node metastasis in the LPLD group was 16% (4/25), of which 12% (3/25) were on the left side and 4% (1/25) were on the right side. The rate of intraoperative complications in the LPLD group was significantly higher at 16.0% (4/25) compared with 3.3% (3/92) in the TME only group (p = 0.037). There were no statistically significant differences in the rate of postoperative complications between the two groups (24.0% of patients in the LPLD group compared with 26.1% patients in the no LPLD group, p = 0.832). CONCLUSION: Pelvic lymphadenectomy has an important role in the treatment of advanced lower rectal cancer. LPLD is a safe and feasible procedure. However, it is necessary to study a larger number of patients with a longer follow-up period to fully evaluate oncological outcomes.
Subject(s)
Laparoscopy , Rectal Neoplasms , Asian People , Humans , Lymph Node Excision , Rectal Neoplasms/surgery , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND: Esophageal cancer is the fourth-most-common cancerous disease of the gastrointestinal tract, with increasing incidence rates. AIM: The present study aimed to assess the outcomes of right thoracoscopic esophagectomy combined with laparotomy for esophageal cancer treatment in Vietnamese patients. METHODS: A cross-sectional study of 71 patients was conducted at 108 Military Central Hospital, Hanoi, Vietnam, from January 2010 to December 2017. RESULTS: Right thoracoscopic esophagectomy combined with laparotomy was performed in 71 patients with esophageal cancer. The mean patient age was 55.8 years, and 100% were male. Patients were diagnosed with the following cancer stages: Stage 0: 4.2%; Stage I: 14.1%; Stage II: 59.2%; and Stage III: 22.5%. The lymph node metastasis rate was 33.8%. The overall complication rate was 42.3%, which included a pneumonia rate of 12.3%, a respiratory failure rate of 7.0%, an anastomotic leak rate of 11.3%, and a chylothorax rate of 4.2%. The mean postoperative time was 16.4 days. The mean follow-up time was 21.7 months. The median overall survival was 45.7 months. The 1-year, 2-year, 3-year, and 4-year survival rates were 79.7%, 62.3%, 52.3%, and 43.6%, respectively. CONCLUSIONS: Thoracoscopic esophagectomy combined with laparotomy for esophageal cancer was a safe, effective, and minimally invasive procedure that should play a continued role in cancer treatment.
