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Posted by on Nov 17, 2019 in Colorectal cancer | 0 comments

In a nutshell

This study compared the effectiveness of open and non-invasive surgery (NIS) in the treatment of rectal cancer. Researchers suggested that open surgery is associated with improved complete tumor removal, while NIS is associated with fewer complications.

Some background

Colorectal cancer is one of the most common cancers in the US. The standard treatment is chemotherapy and open surgery. Prior studies showed that open surgery was associated with a local recurrence (when cancer comes back) of just 3.7%.

NIS methods such as laparoscopic and robotic surgery have been associated with improved recovery outcomes. In laparoscopic surgery, a tube with a camera is inserted in the body. This tube will then be used to remove the tumor. The robotic surgery consists in the use of robotic arms during surgery. If the tumor is completely removed, all three methods will have similar survival outcomes. However, it has been shown that open surgery is associated with improved tumor removal.

Another study suggested that patients undergoing robotic surgery were less likely to change to open surgery. In some cases, after starting NIS, doctors decide to change to open surgery. This is usually to do with tumor size and/or location. It is important to compare the 3 surgery options for patients with rectal cancer.

Methods & findings

This study analyzed 22 other studies comparing open, laparoscopic, and robotic surgery for rectal cancer. It included information about 4882 patients overall.

Patients in the open surgery group were more likely to have complete tumor removal. They had an 85% probability of complete tumor removal. This was followed by robotic (63%) and then laparoscopic surgery (2%). However, NIS was associated with fewer complications and a lower mortality rate. Robotic surgery was associated with the best lymph node removal.

The bottom line

This study concluded that open surgery gives the best tumor removal rate, while NIS is associated with fewer complications and better survival.

The fine print

This study was based on information from medical records. Data may have been missing. Further studies are needed.

Published By :

Colorectal Disease

Date :

Oct 10, 2019

Original Title :

A comparison of open, laparoscopic and robotic TME: trial sequential analysis and network meta-analysis.

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