Comparison of short-term effect between laparoscopic and open Miles operations for lower rectal carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YU Cihu ,  SUN Libo , ZHANG Haishan , SU Yanzhuo , WANG Bo , YIN Weixiang , FANG Xuedong

Department of Gastrointestinal Colorectal and Anal Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, P. R. China;

Corresponding author：

SUN Libo, Email: sunlibo0431@sina.com

Keywords：

lower rectal carcinoma; laparoscopy; open operation

DOI：

10.7507/1007-9424.201712076

Video：

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Objective To evaluate short-term effect of laparoscopic and open Miles operations for lower rectal carcinoma. Methods A total of 119 patients with lower rectal carcinoma were retrospectively collected from March 2012 to March 2017 in this hospital, among which 65 were in the laparoscopic operation group and 54 in the open operation group. The perioperative data, pathological results, recovery courses, and complications were compared between the two groups. Results Compared with the open operation group, the laparoscopic group showed a longer operation time (t=6.035, P=0.002), quicker bowel function recovery (t=4.919, P<0.001), faster off-bed activity (t=2.221, P<0.001), and shorter hospital stay time (t=3.795, P=0.025). The intraoperative blood loss (t=0.154, P=0.698) and the number of harvested lymph nodes (t=0.532, P=0.595) were similar between the two groups. The laparoscopic operation group showed a significant lower total complication rate (χ²=7.174, P=0.009) as compared with the open operation group, but the incision infection, urinary tract injury, lung infection, thrombosis of lower extremities, etc. had no significant differences between the two groups (P>0.050). Conclusion Laparoscopic Miles operation improves postoperative recovery and reduces postoperative complications as compared with open approach in treatment of lower rectal cancer, with similar oncological and short-term results.

Citation： YU Cihu, SUN Libo, ZHANG Haishan, SU Yanzhuo, WANG Bo, YIN Weixiang, FANG Xuedong. Comparison of short-term effect between laparoscopic and open Miles operations for lower rectal carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2018, 25(7): 832-836. doi: 10.7507/1007-9424.201712076 Copy

1.	De Nardi P, Summo V, Vignali A, et al. Standard versus extralevator abdominoperineal low rectal cancer excision outcomes: a systematic review and meta-analysis. Ann Surg Oncol, 2015, 22(9): 2997-3006.
2.	Campos FG, Habr-Gama A, Nahas SC, et al. Abdominoperineal excision: evolution of a centenary operation. Dis Colon Rectum, 2012, 55(8): 844-853.
3.	van der Pas MH, Haglind E, Cuesta MA, et al. Laparoscopic versus open surgery for rectal cancer (COLOR Ⅱ): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol, 2013, 14(3): 210-218.
4.	Zhou ZX, Zhao LY, Lin T, et al. Long-term oncologic outcomes of laparoscopic vs open surgery for stages Ⅱ and Ⅲ rectal cancer: A retrospective cohort study. World J Gastroenterol, 2015, 21(18): 5505-5512.
5.	Laurent C, Leblanc F, Wütrich P, et al. Laparoscopic versus open surgery for rectal cancer: long-term oncologic results. Ann Surg, 2009, 250(1): 54-61.
6.	Mistrangelo M, Allaix ME, Cassoni P, et al. Laparoscopic versus open resection for transverse colon cancer. Surg Endosc, 2015, 29(8): 2196-2202.
7.	Zeng WG, Liu MJ, Zhou ZX, et al. Outcome of laparoscopic versus open resection for transverse colon cancer. J Gastrointest Surg, 2015, 19(10): 1869-1874.
8.	Ortiz H, Ciga MA, Armendariz P, et al. Multicentre propensity score-matched analysis of conventional versus extended abdominoperineal excision for low rectal cancer. Br J Surg, 2014, 101(7): 874-882.
9.	Feng F, Li XH, Shi H, et al. Fast-track surgery combined with laparoscopy could improve postoperative recovery of low-risk rectal cancer patients: a randomized controlled clinical trial. J Dig Dis, 2014, 15(6): 306-313.
10.	Shen Z, Ye Y, Zhang X, et al. Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer. Eur J Surg Oncol, 2015, 41(4): 472-477.
11.	梁耀泽, 余江, 张策, 等. 腹腔镜与同期开腹直肠癌根治术后肿瘤学结果对比研究. 中国普外基础与临床杂志, 2010, 17(6): 591-595.
12.	Larach SW, Salomon MC, Williamson PR, et al. Laparoscopic assisted abdominoperineal resection. Surg Laparosc Endosc, 1993, 3(2): 115-118.
13.	Decanini C, Milsom JW, Bhm B, et al. Laparoscopic oncologic abdominoperineal resection. Dis Colon Rectum, 1994, 37(6): 552-558.
14.	Jeong SY, Park JW, Nam BH, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol, 2014, 15(7): 767-774.
15.	Wang YW, Huang LY, Song CL, et al. Laparoscopic vs open abdominoperineal resection in the multimodality management of low rectal cancers. World J Gastroenterol, 2015, 21(35): 10174-10183.
16.	Kang SB, Park JW, Jeong SY, et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol, 2010, 11(7): 637-645.
17.	Hsu TC. Abdominoperineal resection without an abdominal incision for rectal cancer has the advantage of no abdominal wound complication and easier stoma care. Am Surg, 2012, 78(2): 166-170.
18.	Cassidy MR, Rosenkranz P, McAneny D. Reducing postoperative venous thromboembolism complications with a standardized risk-stratified prophylaxis protocol and mobilization program. J Am Coll Surg, 2014, 218(6): 1095-1104.
19.	钱峻, 朱杰, 莫琪, 等. 腹腔镜与开腹直肠癌 Miles 手术对会阴部伤口愈合的影响. 中国普外基础与临床杂志, 2010, 17(10): 1017-1020.
20.	Lee E, Kang SB, Choi SI, et al. Prospective study on the incidence of postoperative venous thromboembolism in korean patients with colorectal cancer. Cancer Res Treat, 2016, 48(3): 978-989.
21.	Carruzzo P, Méan M, Limacher A, et al. Association between smoking and recurrence of venous thromboembolism and bleeding in elderly patients with past acute venous thromboembolism. Thromb Res, 2016, 138: 74-79.
22.	Bartlett MA, Mauck KF, Daniels PR. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vasc Health Risk Manag, 2015, 11: 461-477.
23.	Shussman N, Wexner SD. Current status of laparoscopy for the treatment of rectal cancer. World J Gastroenterol, 2014, 20(41): 15125-15134.
24.	Toda S, Kuroyanagi H. Laparoscopic surgery for rectal cancer: current status and future perspective. Asian J Endosc Surg, 2014, 7(1): 2-10.
25.	Oyasiji T, Baldwin K, Katz SC, et al. Feasibility of purely laparoscopic resection of locally advanced rectal cancer in obese patients. World J Surg Oncol, 2012, 10: 147.
26.	Chau A, Maggiori L, Debove C, et al. Toward the end of abdominoperineal resection for rectal cancer? An 8-year experience in 189 consecutive patients with low rectal cancer. Ann Surg, 2014, 260(5): 801-805.

1. De Nardi P, Summo V, Vignali A, et al. Standard versus extralevator abdominoperineal low rectal cancer excision outcomes: a systematic review and meta-analysis. Ann Surg Oncol, 2015, 22(9): 2997-3006.
2. Campos FG, Habr-Gama A, Nahas SC, et al. Abdominoperineal excision: evolution of a centenary operation. Dis Colon Rectum, 2012, 55(8): 844-853.
3. van der Pas MH, Haglind E, Cuesta MA, et al. Laparoscopic versus open surgery for rectal cancer (COLOR Ⅱ): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol, 2013, 14(3): 210-218.
4. Zhou ZX, Zhao LY, Lin T, et al. Long-term oncologic outcomes of laparoscopic vs open surgery for stages Ⅱ and Ⅲ rectal cancer: A retrospective cohort study. World J Gastroenterol, 2015, 21(18): 5505-5512.
5. Laurent C, Leblanc F, Wütrich P, et al. Laparoscopic versus open surgery for rectal cancer: long-term oncologic results. Ann Surg, 2009, 250(1): 54-61.
6. Mistrangelo M, Allaix ME, Cassoni P, et al. Laparoscopic versus open resection for transverse colon cancer. Surg Endosc, 2015, 29(8): 2196-2202.
7. Zeng WG, Liu MJ, Zhou ZX, et al. Outcome of laparoscopic versus open resection for transverse colon cancer. J Gastrointest Surg, 2015, 19(10): 1869-1874.
8. Ortiz H, Ciga MA, Armendariz P, et al. Multicentre propensity score-matched analysis of conventional versus extended abdominoperineal excision for low rectal cancer. Br J Surg, 2014, 101(7): 874-882.
9. Feng F, Li XH, Shi H, et al. Fast-track surgery combined with laparoscopy could improve postoperative recovery of low-risk rectal cancer patients: a randomized controlled clinical trial. J Dig Dis, 2014, 15(6): 306-313.
10. Shen Z, Ye Y, Zhang X, et al. Prospective controlled study of the safety and oncological outcomes of ELAPE procure with definitive anatomic landmarks versus conventional APE for lower rectal cancer. Eur J Surg Oncol, 2015, 41(4): 472-477.
11. 梁耀泽, 余江, 张策, 等. 腹腔镜与同期开腹直肠癌根治术后肿瘤学结果对比研究. 中国普外基础与临床杂志, 2010, 17(6): 591-595.
12. Larach SW, Salomon MC, Williamson PR, et al. Laparoscopic assisted abdominoperineal resection. Surg Laparosc Endosc, 1993, 3(2): 115-118.
13. Decanini C, Milsom JW, Bhm B, et al. Laparoscopic oncologic abdominoperineal resection. Dis Colon Rectum, 1994, 37(6): 552-558.
14. Jeong SY, Park JW, Nam BH, et al. Open versus laparoscopic surgery for mid-rectal or low-rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): survival outcomes of an open-label, non-inferiority, randomised controlled trial. Lancet Oncol, 2014, 15(7): 767-774.
15. Wang YW, Huang LY, Song CL, et al. Laparoscopic vs open abdominoperineal resection in the multimodality management of low rectal cancers. World J Gastroenterol, 2015, 21(35): 10174-10183.
16. Kang SB, Park JW, Jeong SY, et al. Open versus laparoscopic surgery for mid or low rectal cancer after neoadjuvant chemoradiotherapy (COREAN trial): short-term outcomes of an open-label randomised controlled trial. Lancet Oncol, 2010, 11(7): 637-645.
17. Hsu TC. Abdominoperineal resection without an abdominal incision for rectal cancer has the advantage of no abdominal wound complication and easier stoma care. Am Surg, 2012, 78(2): 166-170.
18. Cassidy MR, Rosenkranz P, McAneny D. Reducing postoperative venous thromboembolism complications with a standardized risk-stratified prophylaxis protocol and mobilization program. J Am Coll Surg, 2014, 218(6): 1095-1104.
19. 钱峻, 朱杰, 莫琪, 等. 腹腔镜与开腹直肠癌 Miles 手术对会阴部伤口愈合的影响. 中国普外基础与临床杂志, 2010, 17(10): 1017-1020.
20. Lee E, Kang SB, Choi SI, et al. Prospective study on the incidence of postoperative venous thromboembolism in korean patients with colorectal cancer. Cancer Res Treat, 2016, 48(3): 978-989.
21. Carruzzo P, Méan M, Limacher A, et al. Association between smoking and recurrence of venous thromboembolism and bleeding in elderly patients with past acute venous thromboembolism. Thromb Res, 2016, 138: 74-79.
22. Bartlett MA, Mauck KF, Daniels PR. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vasc Health Risk Manag, 2015, 11: 461-477.
23. Shussman N, Wexner SD. Current status of laparoscopy for the treatment of rectal cancer. World J Gastroenterol, 2014, 20(41): 15125-15134.
24. Toda S, Kuroyanagi H. Laparoscopic surgery for rectal cancer: current status and future perspective. Asian J Endosc Surg, 2014, 7(1): 2-10.
25. Oyasiji T, Baldwin K, Katz SC, et al. Feasibility of purely laparoscopic resection of locally advanced rectal cancer in obese patients. World J Surg Oncol, 2012, 10: 147.
26. Chau A, Maggiori L, Debove C, et al. Toward the end of abdominoperineal resection for rectal cancer? An 8-year experience in 189 consecutive patients with low rectal cancer. Ann Surg, 2014, 260(5): 801-805.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison of short-term effect between laparoscopic and open Miles operations for lower rectal carcinoma

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