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Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer
Purpose Minimally invasive rectal cancer (RC) resection has become common, despite recent high-profile trials failing to show non-inferiority to open proctectomy. We hypothesized that at a high-volume center, laparoscopic resection may have superior outcomes compared to those seen in ALaCaRT and ACO...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Cureus
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226664/ https://www.ncbi.nlm.nih.gov/pubmed/32419994 http://dx.doi.org/10.7759/cureus.7666 |
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author | Ofshteyn, Asya Weaver, Allson B Brady, Justin T Idrees, Jay Coronado, Wendy M Steele, Scott R Reynolds, Harry Steinhagen, Emily Stein, Sharon L |
author_facet | Ofshteyn, Asya Weaver, Allson B Brady, Justin T Idrees, Jay Coronado, Wendy M Steele, Scott R Reynolds, Harry Steinhagen, Emily Stein, Sharon L |
author_sort | Ofshteyn, Asya |
collection | PubMed |
description | Purpose Minimally invasive rectal cancer (RC) resection has become common, despite recent high-profile trials failing to show non-inferiority to open proctectomy. We hypothesized that at a high-volume center, laparoscopic resection may have superior outcomes compared to those seen in ALaCaRT and ACOSOG Z6051. Methods Retrospective review of patients undergoing laparoscopic proctectomy from 2007 to 2015 for RC was performed at a high-volume center. Primary outcome was successful resection defined by negative circumferential resection margin (CRM) and distal margin (DM), and complete total mesorectal excision (TME). Results A total of 89 patients were included. Of 33 patients with TME grading, 31 (93.9%) had complete/near complete TME, and 29 (87.9%) had a “successful resection” compared with 81.7% in ACOSOG and 82% in ALaCART trials using same criteria. CRM was ≥1 mm in 87 (97.8%) of patients. Mean DM was 3.8 cm; 97.8% of patients had negative DM. Conclusion High-volume centers can achieve similar high quality RC outcomes to those demonstrated in recent trials. Institutional outcomes should determine optimal surgical technique. |
format | Online Article Text |
id | pubmed-7226664 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Cureus |
record_format | MEDLINE/PubMed |
spelling | pubmed-72266642020-05-15 Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer Ofshteyn, Asya Weaver, Allson B Brady, Justin T Idrees, Jay Coronado, Wendy M Steele, Scott R Reynolds, Harry Steinhagen, Emily Stein, Sharon L Cureus General Surgery Purpose Minimally invasive rectal cancer (RC) resection has become common, despite recent high-profile trials failing to show non-inferiority to open proctectomy. We hypothesized that at a high-volume center, laparoscopic resection may have superior outcomes compared to those seen in ALaCaRT and ACOSOG Z6051. Methods Retrospective review of patients undergoing laparoscopic proctectomy from 2007 to 2015 for RC was performed at a high-volume center. Primary outcome was successful resection defined by negative circumferential resection margin (CRM) and distal margin (DM), and complete total mesorectal excision (TME). Results A total of 89 patients were included. Of 33 patients with TME grading, 31 (93.9%) had complete/near complete TME, and 29 (87.9%) had a “successful resection” compared with 81.7% in ACOSOG and 82% in ALaCART trials using same criteria. CRM was ≥1 mm in 87 (97.8%) of patients. Mean DM was 3.8 cm; 97.8% of patients had negative DM. Conclusion High-volume centers can achieve similar high quality RC outcomes to those demonstrated in recent trials. Institutional outcomes should determine optimal surgical technique. Cureus 2020-04-14 /pmc/articles/PMC7226664/ /pubmed/32419994 http://dx.doi.org/10.7759/cureus.7666 Text en Copyright © 2020, Ofshteyn et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | General Surgery Ofshteyn, Asya Weaver, Allson B Brady, Justin T Idrees, Jay Coronado, Wendy M Steele, Scott R Reynolds, Harry Steinhagen, Emily Stein, Sharon L Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer |
title | Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer |
title_full | Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer |
title_fullStr | Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer |
title_full_unstemmed | Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer |
title_short | Institutional Outcomes Should Be a Determinant in Decision to Perform Laparoscopic Proctectomies for Rectal Cancer |
title_sort | institutional outcomes should be a determinant in decision to perform laparoscopic proctectomies for rectal cancer |
topic | General Surgery |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7226664/ https://www.ncbi.nlm.nih.gov/pubmed/32419994 http://dx.doi.org/10.7759/cureus.7666 |
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