Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review  

作　　者：Kai Siang Chan Biquan Liu Ming Ngan Aloysius Tan Kwang Yeong How Kar Yong Wong 

机构地区：[1]Department of General Surgery,Tan Tock Seng Hospital,Singapore 308433,Singapore

出　　处：《World Journal of Gastrointestinal Surgery》2024年第3期777-789,共13页世界胃肠外科杂志（英文版）（电子版）

基　　金：Informed consent was obtained from patients included(No.SDB-2023-0069-TTSH-01).

摘　　要：BACKGROUND Colorectal cancer is the third most common cancer and the second highest cause of cancer-related mortality worldwide.About 5%-10%of patients are diagnosed with locally advanced rectal cancer(LARC)on presentation.For LARC invading into other structures(i.e.T4b),multivisceral resection(MVR)and/or pelvic ex-enteration(PE)remains the only potential curative surgical treatment.MVR and/or PE is a major and complex surgery with high post-operative morbidity.Minimally invasive surgery(MIS)has been shown to improve short-term post-operative outcomes in other gastrointestinal malignancies,but there is little evi-dence on its use in MVR,especially so for robotic MVR.This is a single-center retrospective cohort study from 1st January 2015 to 31st March 2023.Inclusion criteria were patients diagnosed with cT4b rectal cancer and underwent MVR,or stage 4 disease with resectable systemic metastases.Pa-tients who underwent curative MVR for locally recurrent rectal cancer,or me-tachronous rectal cancer were also included.Exclusion criteria were patients with systemic metastases with non-resectable disease.All patients planned for elective surgery were enrolled into the standard enhanced recovery after surgery pathway with standard peri-operative management for colorectal surgery.Complex sur-gery was defined based on technical difficulty of surgery(i.e.total PE,bladder-sparing prostatectomy,pelvic lymph node dissection or need for flap creation).Our primary outcomes were the margin status,and complication rates.Cate-gorical values were described as percentages and analysed by the chi-square test.Continuous variables were expressed as median(range)and analysed by Mann-Whitney U test.Cumulative overall survival(OS)and recurrence-free survival(RFS)were analysed using Kaplan-Meier estimates with life table analysis.Log-rank test was performed to determine statistical significance between cumulative estimates.Statistical significance was defined as P<0.05.Meier estimates with life table analysis.Log-rank test was performed to

关 键 词：LAPAROSCOPY Minimally invasive surgical procedures Multivisceral resection Pelvic Exenteration Rectal neoplasms Robotic surgical procedures 

分 类 号：R735.37[医药卫生—肿瘤]