Laparoscopic TME for Rectal Cancer

Abstract

Laparoscopic colonic resection for cancer is becoming well established within the surgical community. However, the current evidence for laparoscopic total mesorectal excision (TME) is scanty but does point toward a potential for improved short-term outcomes and oncological equivalency to open resection. Patients undergoing laparoscopic TME for rectal cancer in 1 hospital between October 2003 and December 2010 were analyzed. Data were collated from a prospective database. Survival analysis was calculated using the Kaplan-Meier method. 79 patients were analyzed (96.3% of all TMEs). There was a median length of stay of 5 days, with no postoperative mortality. The 5-year overall survival was 70% and the 5-year disease-free survival was 65.5%. There was a conversion rate of 10.1%. The 5-year overall survival for completed laparoscopic cases was 70.6% versus 62.5% for converted cases (P=0.041). There seems to be increasing evidence that laparoscopic TME is equivalent to open TME for rectal cancer. Conversion may be deleterious to overall survival.