Akademik Veri Yönetim Sistemi
7. Scientific and Annual Meeting of the European Society of Coloproctology, Viyana, Avusturya, 26 - 28 Eylül 2012, cilt.14, ss.1-76
Aim: Showing the long term oncologic outcomes of the standardized laparoscopic rectum cancer
surgery.
Method: Consecutive 106 rectum cancer patients who were underwent laparoscopic rectal surgery
were evaluated. All cases were operated by a single surgeon with standardized technique. Technique
includes ligation of the inferior mesenteric artery at the origin while seeing and preserving the superior
hypogastric plexus, sharp dissection with unipolar cautery was applied for medial to lateral mobilizing
of left colon and total mesorectal excision. Demographic data, pathologic results and oncologic
follow-up were registered prospectively.
Results: Median follow-up is 61 months. 64 (60%) cases were underwent neoadjuvant treatment.
Conversion to open was seen in 12 cases (11.3%). Circumferential surgical margin involvement was
seen in six cases (5.7%). R0 resection was performed in 100 cases (94.3%). Local recurrence was
occurred in five cases (4.7%), disease free survival is 82.7% for 5 years follow-up, also overall survival
was 83.4% and local recurrence free survival was 95%.
Conclusion: Laparoscopic rectal cancer resections still remain controversial due to fears that
oncologic and pathologic principles will be compromised. Laparoscopic technique must provide the
integrity of the mesorectum and negative circumferential margin. Standardized laparoscopic technique
after supplementing learning curve could provide good oncologic outcomes.