Short-term Outcomes of Transanal versus Laparoscopic Total Mesorectal Excision: A Systematic Review and Meta-Analysis of Cohort Studies
Conclusion: The present systematic review and meta-analysis suggested some advantages of TaTME, in terms of circumferential resection margin involvement, operative time, blood loss, conversion, hospital stay, overall postoperative complications, and readmission. It appears that the TaTME procedure achieved a better resection quality and smoother recovery in selected patients, without compromising the short-term safety. Nevertheless, it is too early to draw any conclusion, since results of high quality clinical evidence from randomized controlled trials have to be awaited. As it is technically demanding, the procedure needs to be taught and learned systematically to ensure safe implementation.
ConclusionsThis report investigates significant predictors of stoma outlet obstruction in laparoscopic rectal cancer surgery for the first time. In laparoscopic procedure, stoma outlet obstruction should be particularly considered in obese patients who have especially thick subcutaneous fat of the abdominal wall.
ConclusionsIn this study on patients undergoing laparoscopic rectal resection, VO was not associated with development of AL or other complications. However, we found that visceral obesity was associated with an increased risk of conversion to open surgery.
CONCLUSIONS: We conclude that this technique is a feasible, safe and valid adjunct to the double staple technique whenever intraabdominal application of the linear staple is difficult or unsafe. KEY WORDS: Colorectal cancer, Laparoscopic anterior resection, Double, Low colorectal anastomosis, Stapling technique. PMID: 30862771 [PubMed - in process]
This study evaluated the oncologic impact of obesity, as determined by body mass index (BMI), in patients who underwent laparoscopic surgery for rectal cancer. Methods: The records of 483 patients with stage I-III rectal cancer who underwent laparoscopic surgery between June 2003 and December 2011 were reviewed. A matching model based on BMI was constructed to balance obese and nonobese patients. Cox hazard regression models for overall survival (OS) and disease-free survival (DFS) were used for multivariate analyses. Additional analysis using visceral fat area (VFA) measurement was performed for matched patients. The ...
CONCLUSIONS: Adopting these strategies can facilitate laparoscopic mesorectal excision in the obese patient and may reduce conversion to open.
Publication date: Available online 15 November 2018Source: European Journal of Surgical OncologyAuthor(s): Julia K. Grass, Daniel R. Perez, Jakob R. Izbicki, Matthias ReehAbstractSeveral patients' and pathological characteristics in rectal surgery can significantly complicate surgical loco regional tumor clearance. The main factors are obesity, short tumor distance from anal verge, bulky tumors, and narrow pelvis, which have been shown to be associated to poor surgical results in open and laparoscopic approaches. Minimally invasive surgery has the potential to reduce perioperative morbidity with equivalent short- and long-...
The benefits of minimally invasive surgery in obese patients are well documented in colorectal surgery. However, comparative outcomes among obese patients is not well characterized. Here, we utilize the Nationwide Inpatient Sample (NIS) to compare morbidity and mortality between varying levels of BMI in patients who underwent laparoscopic abdominoperineal resection LAPR for rectal cancer.
In this study, perioperative and short-term postoperative results of totally robotic versus totally laparoscopic rectal resections for cancer were investigated in a comparative manner by considering risk factors including obesity, male sex, and neoadjuvant treatment. In addition to overall comparison, the impact of sex, obesity (body mass index ≥30 kg/m2), and neoadjuvant treatment was assessed in patients who had a total mesorectal excision (TME). Operative time was longer in the robotic group (P
ConclusionObesity did not impact severe morbidity or conversion rate following RAS for rectal cancer but remained a risk factor for overall morbidity and especially postoperative ileus.
Conclusion: Radiation attenuation was associated with overall and grade 3 –5 postoperative morbidity after neoadjuvant chemoradiation and non-laparoscopic resection for rectal cancer. Sarcopenic obesity was associated with overall complications.Dig Surg