Long-term outcome of rectal cancer patients following laproscopic surgery

This study investigated the long-term outcome of patients after laparoscopic total mesorectal excision (a significant length of bowel tissue around the tumor is removed with only a minor surgical incision).

Surgery is the main method for treating rectal cancer. Open surgery is the original surgical method used for rectal cancer, which involves making a large incision into the patient. Laparoscopic surgery is a new, minimally invasive method of performing total mesorectal excision (TME, removal of a large portion of the bowel surrounding the tumor). The short-term benefits of laparoscopic surgery are clear: shorter recovery time and shorter hospital stay. However, the long-term benefits of laparoscopic surgery for middle or low rectal cancer have not been fully researched.

Data for 132 patients who underwent laparoscopic TME was examined in this study. For 46.2% of patients the cancer affected the middle rectum and for 53.8% it affected the low rectum. Patients were followed for an average of 85.9 months. Mortality and post-surgery complications were analyzed.

Complete mesorectal excision was achieved for 97% of patients. One patient died following surgery due to a heart attack. 18.2% of patients suffered from major surgical complications. The most common surgical complications were problems urinating and anastomotic leakage (leaking of fluid from the point where the intestines are reconnected after removal of the tumor).

79.8% of patients remained disease free after 5 years and 73% after 10 years. 83% of patients survived 5 years and 71% of patients survived 10 years after surgery. Results after 18 years matched those seen after 10 years.

More advanced cancer at diagnosis was linked to worse patient outcome. For patients whose cancer had spread to distant organs (stage IV) the rate of remaining cancer free was lowest: 31% after 5 years and 0% after 10 years. Overall survival rate was also lower for patients with stage IV cancer: 56% at 5 years and 0% at 10 years.

The authors concluded that the long-term outcome of patients who underwent laparoscopic surgery is similar to results reported for patients who undergo open surgery.