TY - JOUR AU - Fujishima, Hajime AU - Shiroshita, Hidefumi AU - Hara, Takao AU - Itai, Yusuke AU - Sagawa, Noriko AU - Ma, Jianwei AU - Nakajima, Kentaro AU - Kono, Yohei AU - Hiratsuka, Takahiro AU - Suzuki, Kosuke AU - Akagi, Tomonori AU - Shibata, Tomotaka AU - Ueda, Yoshitake AU - Tojigamori, Manabu AU - Etoh, Tsuyoshi AU - Shiraishi, Norio AU - Inomata, Masafumi PY - 2018 TI - Clinical impact of laparoscopic intersphincteric resection following neoadjuvant chemoradiotherapy for locally advanced rectal cancer: case-controlled study JF - Annals of Laparoscopic and Endoscopic Surgery; Vol 3 (April 2018): Annals of Laparoscopic and Endoscopic Surgery Y2 - 2018 KW - N2 - Background: Recently, laparoscopic (Lap) intersphincteric resection (ISR) for low-lying rectal cancer is gradually permeating worldwide. However, the usefulness of Lap-ISR after neoadjuvant chemoradiotherapy (NCRT) has not been clarified. This retrospective study aimed to evaluate the feasibility of Lap-ISR after NCRT for locally advanced low-lying rectal cancer. Methods: Fourteen patients with primary locally low-lying rectal cancer were enrolled in this study and underwent curative Lap-ISR between January 2008 and December 2011. Seven patients underwent Lap-ISR after NCRT (NCRT group) and seven patients underwent Lap-ISR without NCRT (non-NCRT group). Patient characteristics, short-term outcomes, postoperative anal function, and long-term oncological outcomes were evaluated and compared between the groups. Results: The tumor diameter was significantly larger in the NCRT group than the non-NCRT group (38±7 and 28±9 mm, respectively; P=0.04) and cStage was significantly more advanced in the NCRT group than the non-NCRT group (P=0.02). There were no significant differences in operative data or postoperative course between the groups. The Wexner score measured 5 years after initial surgery was significantly higher the NCRT group than the non-NCRT group (8.8±4.1 and 4.6±1.9, respectively; P=0.04). There were no significant differences in local recurrence rate, distant recurrence rate, or cancer-specific death rate between the two groups (median follow-up period was 60 months). Conclusions: Lap-ISR after NCRT is a feasible treatment option based on short-term outcomes, long-term oncological outcomes, and postoperative anal function. These data suggest that Lap-ISR after NCRT may be an appropriate treatment option for locally advanced low-lying rectal cancer. UR - https://ales.amegroups.org/article/view/4475