Outcomes of Minimally Invasive Rectal Cancer Resection: Insights From a Resource-Limited Setting.

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2024-12-23 DOI:10.1002/jso.28060

Abinaya R Nadarajan, Chandramohan Krishnan Nair, Madhu Muralee, Mira Sudam Wagh, Anoop T M, Preethi Sara George

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引用次数: 0

Abstract

Background: Minimally invasive approaches for rectal cancer treatment are emerging as the standard of care. Robotic surgery is unfeasible across the country due to constrained resource allocation. This study aimed to assess the oncologic efficacy of laparoscopic resection for rectal cancer in a resource-limited setting.

Methods: A propensity score-matched analysis was carried out to compare the oncological outcomes of laparoscopic and open rectal cancer resection at a high-volume tertiary cancer centre in South India.

Results: Two hundred and twenty patients were included (110 patients in each group). The median follow-up was 93 months. There was no difference in positive circumferential resection margin between laparoscopic and open group (4.5% vs. 6.4%, p = 0.55), with a significantly better nodal yield in laparoscopic group. There was no significant difference between the laparoscopic and open groups in terms of local recurrence (5.1% vs. 8.3%, p = 0.12), 5-year disease-free survival (86% vs. 81%, p = 0.22, HR 0.699, 95% CI 0.353-1.27) or overall survival (85% vs. 76%, p = 0.21, HR 0.658, 95% CI 0.340-1.27). The mean cost between the two groups had no difference.

Conclusion: In a resource-limited setting with good expertise, laparoscopic surgery is an effective minimally invasive option that has good survival outcomes without imposing a financial burden on patients.

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微创直肠癌切除术的结果：来自资源有限环境的见解。

背景：微创入路治疗直肠癌正逐渐成为标准治疗方法。由于资源分配有限，机器人手术在全国范围内是不可行的。本研究旨在评估在资源有限的情况下腹腔镜直肠癌切除术的肿瘤学疗效。方法：进行倾向评分匹配分析，比较在印度南部一个大容量三级癌症中心腹腔镜和开放式直肠癌切除术的肿瘤学结果。结果：共纳入220例患者，每组110例。中位随访时间为93个月。腹腔镜组和开放组的阳性环切缘差异无统计学意义（4.5% vs. 6.4%, p = 0.55），且腹腔镜组的淋巴结切除率明显高于开放组。腹腔镜组和开放组在局部复发率（5.1%比8.3%,p = 0.12）、5年无病生存率（86%比81%，p = 0.22, HR 0.699, 95% CI 0.353-1.27）或总生存率（85%比76%，p = 0.21, HR 0.658, 95% CI 0.34 -1.27）方面无显著差异。两组之间的平均成本没有差异。结论：在资源有限且具有良好专业知识的情况下，腹腔镜手术是一种有效的微创选择，具有良好的生存结果，且不会给患者带来经济负担。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.