Malignant disease,Rectal cancer
- Spotlight on laparoscopy in the surgical resection of locally advanced rectal cancer: multicenter propensity score match study
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Irfan Ul Islam Nasir, Muhammad Fahd Shah, Sofoklis Panteleimonitis, Nuno Figueiredo, Amjad Parvaiz
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Ann Coloproctol. 2022;38(4):307-313. Published online August 11, 2021
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DOI: https://doi.org/10.3393/ac.2020.01060.0151
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Graphical Abstract
Abstract
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- Purpose
This study was aimed to assess the feasibility of laparoscopic rectal surgery, comparing quality of surgical specimen, morbidity, and mortality.
Methods Prospectively acquired data from consecutive patients undergoing laparoscopic surgery for rectal cancer, at 2 minimally invasive colorectal units, operated by the same team was included. Locally advanced rectal tumors were identified as T3B or T4 with preoperative magnetic resonance imaging scans. All the patients were operated on by the same team. The 1:1 propensity score matching was performed to create a perfect match in terms of tumor height.
Results Total of 418 laparoscopic resections were performed, out of which 109 patients had locally advanced rectal cancer (LARC) and were propensity score matched with non-LARC (NLARC) patients. Median operation time was higher for the LARC group (270 minutes vs. 250 minutes, P=0.011). However, conversion to open surgery was done in 5 vs. 2 patients (P=0.445), reoperation in 8 vs. 7 (P=0.789), clinical anastomotic leak was found in 3 vs. 2 (P=0.670), and 30-day mortality rates was 2 vs. 1 (P>0.999) between LARC and NLARC, respectively. Readmission rate was higher in the NLARC group (33 patients vs. 19 patients, P=0.026), due to stoma-related issues. There was no statistically significant difference in the R0 resection between the 2 groups (99 patients in LARC vs. 104 patients in NLARC, P=0.284).
Conclusion This study demonstrates that standardized approach to laparoscopy is safe and feasible in LARC. Comparable postoperative short-term clinical and pathological outcomes were seen between LARC and NLARC groups.
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Citations
Citations to this article as recorded by 
- Performance reporting design in artificial intelligence studies using image-based TNM staging and prognostic parameters in rectal cancer: a systematic review
Minsung Kim, Taeyong Park, Bo Young Oh, Min Jeong Kim, Bum-Joo Cho, Il Tae Son Annals of Coloproctology.2024; 40(1): 13. CrossRef - Sex Disparities in Rectal Cancer Surgery: An In-Depth Analysis of Surgical Approaches and Outcomes
Chungyeop Lee, In Ja Park The World Journal of Men's Health.2024; 42(2): 304. CrossRef - Robotic surgery for locally advanced T4 rectal cancer: feasibility and oncological quality
Marcos Gomez Ruiz, Roberto Ballestero Diego, Patricia Tejedor, Carmen Cagigas Fernandez, Lidia Cristobal Poch, Natalia Suarez Pazos, Julio Castillo Diego Updates in Surgery.2023; 75(3): 589. CrossRef - How Can We Improve the Tumor Response to Preoperative Chemoradiotherapy for Locally Advanced Rectal Cancer?
Jeonghee Han The Ewha Medical Journal.2023;[Epub] CrossRef - Influence of the COVID-19 Pandemic on the Treatment Patterns and Outcomes of Colorectal Cancer
In Ja Park The Ewha Medical Journal.2023;[Epub] CrossRef - Robot-Assisted Colorectal Surgery
Young Il Kim The Ewha Medical Journal.2022;[Epub] CrossRef - Applications of propensity score matching: a case series of articles published in Annals of Coloproctology
Hwa Jung Kim Annals of Coloproctology.2022; 38(6): 398. CrossRef
Malignant disease,Rectal cancer,Prognosis and adjuvant therapy,Colorectal cancer,Minimally invasive surgery
- Laparoscopy offers better clinical outcomes and long-term survival in patients with right colon cancer: experience from national cancer center
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Muhammad Fahd Shah, Awais Naeem, Ihtisham ul Haq, Shehryar Riaz, Osama Shakeel, Sofoklis Panteleimonitis, Shahid Khattak, Aamir Ali Syed, Amjad Parvaiz
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Ann Coloproctol. 2022;38(3):223-229. Published online June 24, 2021
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DOI: https://doi.org/10.3393/ac.2021.00045.0006
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3,801
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142
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8
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8
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Abstract
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- Purpose
Laparoscopic approach to colonic tumor requires skill set and resources to be established as routine standard of care in most centers around the world. It presents particular challenge in country like Pakistan due to economic constrain and lack of teaching and training opportunities available for surgeons to be trained to deliver such service. The aim of this study is to look into changing practice of our institution from conventional approach of open to laparoscopic surgery for right colon cancer.
Methods Consecutive patients between January 2010 to December 2018 who presented to Shaukat Khanum Memorial Cancer Hospital and Research Centre with diagnosis of right colon (cecum, ascending and transverse colon) adenocarcinoma and underwent surgical resections were included in this study.
Results A total of 230 patients with adenocarcinoma of the right colon underwent curative resections during the study period. Of these, 141 patients (61.3%) underwent laparoscopic surgery while open resection was performed in 89 patients (38.7%). Five-year disease-free survival (DFS) of patients with American Joint Committee on Cancer (AJCC) stage III (80.9% vs. 54.8%, P = 0.021) was significantly better if these patients underwent laparoscopic surgery while a trend toward better DFS (96.7% vs. 84.1%, P = 0.111) was also observed in AJCC stage II patients, although this difference was not significant.
Conclusion This study demonstrates the adoption of a laparoscopic approach for right colon cancer over 10 years. With a standardized approach and using the principle of oncological surgery, we incorporated this in our minimally invasive surgery practice at our institution.
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Citations
Citations to this article as recorded by 
- Short-Term Outcomes of First 100 Laparoscopic Colorectal Surgeries at a Newly Developed Surgical Setup at Peshawar
Muhammad F Shah, Irfan Ul Islam Nasir, Riaz Ahmad, Sajjad Ahmad, Aalia Amjad, Khush Bakht Zaineb, Romana Rehman Cureus.2024;[Epub] CrossRef - Effect of Fluorescence Lymph Node Mapping on Improving Diagnostic Values of CT D3 Lymph Node Staging for Right-Sided Colon Cancer
Gyung Mo Son, Tae Un Kim, Mi Sook Yun, ChangYeop Kim, In Young Lee, Su Bum Park, Dong-Hoon Shin, Gi Won Ha Cancers.2024; 16(20): 3496. CrossRef - Optimal Indocyanine Green Dosage for Repetitive Angiography for Laparoscopic Colorectal Surgery
Gyung Mo Son, Sang-Ho Park, Nam Su Kim, Mi Sook Yun, In Young Lee, Myeong-Sook Kwon, Tae Kyun Kim, Eun Hwa Lee, Eun Jung Hwang, Kwang-Ryul Baek Medicina.2024; 60(12): 1966. CrossRef - Clinical Effectiveness of Fluorescence Lymph Node Mapping Using ICG for Laparoscopic Right Hemicolectomy: A Prospective Case–Control Study
Gyung Mo Son, Mi Sook Yun, In Young Lee, Sun Bin Im, Kyung Hee Kim, Su Bum Park, Tae Un Kim, Dong-Hoon Shin, Armaan M. Nazir, Gi Won Ha Cancers.2023; 15(20): 4927. CrossRef - Do Laparoscopic Approaches Ensure Oncological Safety and Prognosis for Serosa-Exposed Colon Cancer? A Comparative Study against the Open Approach
Ji-Hyun Seo, In-Ja Park Cancers.2023; 15(21): 5211. CrossRef - Fluorescence-guided colorectal surgery: applications, clinical results, and protocols
Jin-Min Jung, In Ja Park, Eun Jung Park, Gyung Mo Son Annals of Surgical Treatment and Research.2023; 105(5): 252. CrossRef - Ileal long-segment ischemia after the unintended ligation of variant ileal branch during laparoscopic right hemicolectomy
Gyung Mo Son, Tae Un Kim, Dong-Hoon Shin, Joo-Young Na, In Young Lee, Shin Hoo Park Journal of Minimally Invasive Surgery.2022; 25(3): 116. CrossRef - Is Laparoscopic Complete Mesocolic Excision and Central Vascular Ligation Really Necessary for All Patients With Right-Sided Colon Cancer?
Gyung Mo Son, In Young Lee, Yoon Suk Lee, Bong-Hyeon Kye, Hyeon-Min Cho, Je-Ho Jang, Chang-Nam Kim, Kil Yeon Lee, Suk-Hwan Lee, Jun-Gi Kim Annals of Coloproctology.2021; 37(6): 434. CrossRef
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