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Feasibility and oncological outcomes of laparoscopic rectal resection following neo-adjuvant chemo-radiotherapy: A systematic review

查看全文 作　　者：Pawan Kumar Dhruva [1]Rao;Manojkumar S [1]Nair;Puthucode N [1,2]Haray 高影响力作者 机构地区：[1]Department of Colorectal Surgery,Prince Charles Hospital;[2]University of South Wales高影响力机构 出　　处：《World Journal of Surgical Procedures》索引2015年第5卷第1期,共8页高影响力期刊 摘　　要：AIM: To study the feasibility and oncological outcomesfollowing laparoscopic total mesorectal excision(LTME) in patients who have received Neo-adjuvant long course chemo-radiotherapy(LCRT). METHODS: A protocol driven systematic review of published literature was undertaken to assess the feasibility and oncological outcomes following LTME in patients receiving LCRT. The feasibility was assessed using peri-operative outcomes and short term results. The oncological outcomes were assessed using local recurrence, disease free survival and overall survival.RESULTS: Only 8 studies-1 randomized controlled trial, 4 Case Matched/Controlled Studies and 3 Case Series were identified matching the search criteria. The conversion rate was low(1.2% to 28.1%), anastomotic leak rates were similar to open total mesorectal excision(0%-4.1% vs 0%-8.3%). Only 3 studies reported on local recurrence rates(5.2%-7.6%) at median 34 mo follow-up. A single study described disease free survival and overall survival at 3 years as 78.8% and 92.1% respectively. CONCLUSION: LTME following LCRT is feasible in experienced hands, with acceptable short term surgical outcomes and with the usual benefits associated with minimally invasive procedures. The long term oncological outcomes of LTME after LCRT appear to be comparable to open procedures but need further investigation. 关 键 词：LAPAROSCOPIC total mesorectal EXCISION RECTAL adenocarcinoma FEASIBILITY Outcomes NEOADJUVANT CHEMO-RADIOTHERAPY
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