Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique

Alexander Ferko; Julius Orhalmi; Tomas Dusek; Milan Chobola; Eva Hovorkova; Dimitar Hadzi Nikolov

doi:10.5114/wiitm.2014.45733

eISSN: 2299-0054
ISSN: 1895-4588

Videosurgery and Other Miniinvasive Techniques

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4/2014
vol. 9

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abstract:

Original paper

Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique

Alexander Ferko

,

Julius Orhalmi

,

Tomas Dusek

,

Milan Chobola

,

Eva Hovorkova

,

Dimitar Hadzi Nikolov

Videosurgery Miniinv 2014; 9 (4): 569–577

DOI: https://doi.org/10.5114/wiitm.2014.45733

Online publish date: 2014/10/07

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AMA

Ferko A, Orhalmi J, Dusek T, Chobola M, Hovorkova E, Nikolov D. Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique. Videosurgery and Other Miniinvasive Techniques. 2014:569-577. doi:10.5114/wiitm.2014.45733.

APA

Ferko, A., Orhalmi, J., Dusek, T., Chobola, M., Hovorkova, E.,  & Nikolov, D. (2014). Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique. Videosurgery and Other Miniinvasive Techniques, 569-577. https://doi.org/10.5114/wiitm.2014.45733

Chicago

Ferko, Alexander, Julius Orhalmi, Tomas Dusek, Milan Chobola, Eva Hovorkova,  and Dimitar Hadzi Nikolov. 2014. "Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique". Videosurgery and Other Miniinvasive Techniques: 569-577. doi:10.5114/wiitm.2014.45733.

Harvard

Ferko, A., Orhalmi, J., Dusek, T., Chobola, M., Hovorkova, E.,  and Nikolov, D. (2014). Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique. Videosurgery and Other Miniinvasive Techniques, pp.569-577. https://doi.org/10.5114/wiitm.2014.45733

MLA

Ferko, Alexander et al. "Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique." Videosurgery and Other Miniinvasive Techniques, 2014, pp. 569-577. doi:10.5114/wiitm.2014.45733.

Vancouver

Ferko A, Orhalmi J, Dusek T, Chobola M, Hovorkova E, Nikolov D. Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique. Videosurgery and Other Miniinvasive Techniques. 2014:569-577. doi:10.5114/wiitm.2014.45733.

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Introduction: Currently, the predominant question is whether a laparoscopic approach is comparatively radical in comparison with an open access approach, especially in the circumferential resection margin and quality of the completeness of total mesorectal excision. These factors are important in determining the quality of surgical care as well as long-term results of the treatment.

Aim: This article focuses on the evaluation of circumferential resection margins and on the quality of mesorectal excision of middle and lower rectum tumors. In addition, laparoscopic and open techniques are compared.

Material and methods: Data were collected prospectively and stored in a rectal cancer registry over a 3-year period. The parameters studied were age, sex, body mass index, localization and topography of the tumor, clinical stage, neoadjuvant chemotherapy and its response, the type of surgery, character of the circumferential and distal margins, quality of the mesorectal excision, pT and pN.

Results: One hundred and twenty-five patients were chosen for our study. Laparoscopy was performed in 53 operations and a conventional approach was performed in 72 operations. Complete mesorectal excision was achieved in 54.7% of laparoscopic operations versus 44.4% in the conventional technique; partially complete excision was performed in 20.8 and 12.5%, respectively. Incomplete excisions were described in 24.5 and 43.1% (p = 0.085). Positive circumferential margin occurred during laparoscopic surgery in 11 (20.8%) patients, and in the case of conventional resection in 27 (37.5%) patients (p = 0.044).

Conclusions: Our study showed comparable results between laparoscopic and open access procedures during rectal resection. The results achieved, in particular in the quality of the mesorectal excision and negative circumferential resection margin, show that the laparoscopic approach is comparable to conventional surgical techniques, with an adequate surgical outcome, in the treatment of rectal cancer.

keywords:

Higher risk of incomplete mesorectal excision and positive circumferential margin in low rectal cancer regardless of surgical technique

Alexander Ferko , Julius Orhalmi , Tomas Dusek , Milan Chobola , Eva Hovorkova , Dimitar Hadzi Nikolov

colorectal cancer, total mesorectal excision, circumferential resection margin

Alexander Ferko

,

Julius Orhalmi

,

Tomas Dusek

,

Milan Chobola

,

Eva Hovorkova

,

Dimitar Hadzi Nikolov