Rectal Cancer
Conditions
Brief summary
To compare the open approach and the laparoscopic-assisted approach of dissection of lateral lymph nodes in low advanced rectal cancer patients with clinically suspected nodal metastases in terms of safety, technical feasibility, and patient's oncological outcomes.
Detailed description
the investigators collected data of sixty low advanced cancer rectum patients who underwent either laparoscopic (30 cases) or open total mesorectal excision (30 cases) in addition to lateral pelvic dissection. The duration of operation in the laparoscopically assisted procedure was longer than the open procedure (p=0.003). The postoperative hospital stay time was longer in the open group than in the laparoscopic group (P=0.043). No significant differences between both groups regarding the number of excised lymph nodes, disease recurrence, RFS, or OS rate.
Interventions
PROCEDURElaparoscopic-assited excision of mesorectum with pelvic lymph nodes excision
We performed laparoscopic dissection of the lateral pelvic lymph node for thirty patients while we performed open lateral pelvic lymph node dissection for the remaining thirty patients. Performed surgical approaches were abdominoperineal resection, internal sphincter resection, and low anterior resection. All performed surgical procedures included lateral pelvic lymphadenectomy in addition to performing total mesorectal excision. Choosing whether to perform unilateral or bilateral lymphadenectomy depends on lymph nodes invasion by cancer was on one side or both sides.
Sponsors
Zagazig University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
20 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Patients aged from 20-70 years with * Sure diagnosis of locally advanced (T3 and T4) adenocarcinoma located in the middle or lower part of the rectum * Clinical or radiological evidence of lateral pelvic lymph nodes metastases
Exclusion criteria
* Patients refused to be included in the study, * Patients with concurrent primary cancer in other locations * Patients with recurrent cancer after treatment * Patients with distant metastasis * Previously managed for pelvic cancer
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| operative time | during operative time | time of surgery in minutes |
| operative complication | durning operative time | bleed-injury of organs -failed procedure |
| feasibility of procedure | operative time | easy or difficult |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| mortality | 5 years | number of deaths |
| recurrence | 5 years | recurrent cases |
| post operative morbidity | 5 years | early and late complications |
Outcome results
None listed