Erschienen in:
04.03.2017 | Controversies in Colorectal Surgery
Rectal cancer should not be resected laparoscopically: the rationale and the data
verfasst von:
S. K. Abbas, S. B. Yelika, K. You, J. Mathai, R. Essani, Z. Krivokapić, R. Bergamaschi
Erschienen in:
Techniques in Coloproctology
|
Ausgabe 3/2017
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Excerpt
In 2006, the Cochrane Review [
1] had identified 48 articles describing laparoscopic resection for rectal cancer, although only three of those studies were randomized controlled trials (RCTs) accounting for over 600 patients. These RCTs did not comply with the CONSORT statement [
2] on allocation concealment. Two of the trials provided no data on the distance of the cancer from the anal verge [
3,
4]; hence, it is possible that these trials included rectosigmoid cancers. The CLASICC RCT [
5] provided the only credible source of truly randomized data on laparoscopic resection for rectal cancer at that time. Although not reaching statistical significance (
p = 0.19), the involvement of the circumferential resection margin (CRM) was doubled in the laparoscopic arm as compared to its open counterpart, 12 versus 6%. In the following years, four non-inferiority RCTs comparing laparoscopic to open resection for rectal cancer were launched with the following composite endpoints: CRM, distal margin, total mesorectal excision (TME) quality, local recurrence and 3-year survival. …
