Evaluating the short-term outcome of laparoscopic pelvic exenteration in locally advanced and recurrent rectal cancer.

IF 1.7 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-06-04 DOI:10.1007/s00595-025-03048-4

Kosuke Ozaki, Toshiki Mukai, Yohei Ando, Tatsuki Noguchi, Takashi Sakamoto, Shimpei Matsui, Tomohiro Yamaguchi, Takashi Akiyoshi

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引用次数: 0

Abstract

Purpose: Pelvic exenteration (PE) is sometimes the only curative option for primary rectal cancer as well as locally recurrent rectal cancer (LRRC). However, data on laparoscopic PE (Lap-PE) for LRRC are limited. This study aimed to evaluate the technical safety of Lap-PE in LRRC cases.

Methods: We retrospectively analyzed 63 patients who underwent Lap-PE between January 2013 and December 2023. Patients were categorized into primary (n = 41) and recurrent (n = 22) groups, and short-term outcomes, including operative details and postoperative complications, were compared.

Results: The recurrent group had a significantly higher number of cases of multiple organs resected beyond PE (24.4% vs. 63.6%, p = 0.001). There were no significant differences in the operative time (714 vs. 633 min, p = 0.91) or blood loss (650 vs. 580 g, p = 0.98) between the groups. Clavien-Dindo Grade 3 complications occurred in 29.3% of primary cases and 18.2% of recurrent cases (p = 0.47). R0 resection was achieved in 95.1% of primary cases and 81.8% of recurrent cases (p = 0.10).

Conclusion: Lap PE for LRRC, when performed by an experienced laparoscopic surgical team with careful patient selection, was shown to be safe, with comparable short-term outcomes to those of PE for primary rectal cancer and an acceptable R0 resection rate.

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评估腹腔镜盆腔切除术治疗局部晚期和复发直肠癌的短期疗效。

目的：盆腔切除（PE）有时是原发性直肠癌以及局部复发性直肠癌（LRRC）的唯一治疗选择。然而，腹腔镜下LRRC的PE （Lap-PE）数据有限。本研究旨在评价Lap-PE在LRRC病例中的技术安全性。方法：我们回顾性分析了2013年1月至2023年12月期间接受Lap-PE的63例患者。将患者分为原发组（n = 41）和复发组（n = 22），比较短期预后，包括手术细节和术后并发症。结果：复发组肺外多脏器切除例数明显高于复发组（24.4% vs. 63.6%, p = 0.001）。两组手术时间（714 min vs. 633 min, p = 0.91）和出血量（650 g vs. 580 g, p = 0.98）差异无统计学意义。Clavien-Dindo 3级并发症发生率分别为29.3%和18.2% （p = 0.47）。95.1%的原发病例和81.8%的复发病例实现了R0切除（p = 0.10）。结论：经经验丰富的腹腔镜手术团队和精心挑选的患者进行Lap PE治疗LRRC是安全的，其短期结果与原发性直肠癌的PE相当，R0切除率可接受。

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

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.