Surgery Graund Round Mr Luparini database analysis about Colorectal Team at North Manchester General Hospital

1. Laparoscopic vs Laparotomic Resection for
Rectal Cancer: Our Experience
Francesco Luparini Colorectal Team - North Manchester General Hospital

2. Aim of the Study
Single Centre Study
• Aim: to evaluate the differences of oncological clearance
in Laparoscopic vs. Open Resection for Rectal AdenoCa
Oncological
Clearance
Lymph Node Circumferential
Lesion from Cut End
Retrieval Resection Margin

3. Outline of the Study
Patients’ features
• Retrospective non-randomised study
• Elective admissions for Anterior Resection in AdenoCa:
– 18 Laparoscopic vs. 42 Open
• Period: Nov 2009 - Dec 2011 (25 months)
Laparoscopic Open
Age (m±DS) 67.8 ± 10.7 69.31 ± 12.35
M/F % 55% 59%

4. Duke’s Stage
Distribution in the two groups
• Laparoscopic group: 2 cases of Complete Tumor Regression (CTR) to neoadjuvant
therapy
LAP OPEN
CTR
Tis
A
B
C

5. Venous Invasion
Spreading of AdenoCa through vessels in two groups
No invasion
Venous Invasion
33%
27%
LAP OPEN

6. Results
Lymph nodes retrieval
Lymph nodes LAP OPEN
m ± DS 13.0 ± 5.3 15.7 ± 5.63
With regard to lymph nodes, no
difference has been seen in two
groups (p=NS)

7. Results
Lesion from cut end (mm)
Distance from cut end LAP OPEN
m ± DS 56.4 ± 46.2 65.2 ± 64.9
range 15-200 0-300
With regard to distance of lesion
from cut end, no difference has
been seen in two groups (p=NS)

8. Results
Circumferential Resection Margin (mm)
CRM (mm) LAP OPEN
m ± DS 12.69 ± 7.49 16.42 ± 19.54
range 0 - 25 0 - 70
R1 resection 1/18 2/42
With regard to CRM, no difference has
been seen in two groups (p=NS)

9. Results
Follow-up
• CT scan follow up (months): 8.5 ± 5.2
LAP OPEN
Local Recurrence 1/18 2/42
Metastases 1 lung 1 lung
3 liver 3 liver

10. Conclusions
Retrospective non-randomised study
In our experience Laparoscopic Resection has
proven to be as effective as Open Resection
with regard to:
• Lymph node retrieval
• Distance from cut end
• Circumferential Resection Margin
Further follow-up is needed to evaluate the
Oncological Outcome