Meta‐analysis of the impact of surgical approach on the grade of mesorectal excision in rectal cancer. BJS 2017; 104: 1609-1619.
Published: 17th October 2017
Authors: B. Creavin, M. E. Kelly, E. Ryan, D. C. Winter
The subspecialization of colorectal surgeons, and improvements in the quality of mesorectal excision have revolutionized rectal cancer surgery. With the increasing use of minimally invasive techniques, the completeness of the mesorectal excision has been questioned. This study aimed to assess the pathological outcomes of open
A meta‐analysis of RCTs was undertaken. The primary endpoint was the adequacy of the mesorectal excision. Secondary endpoints included circumferential resection margin and distance to resection margins.
Four studies were included, reporting on 2319 patients; 972 (41·9 per cent) had open and 1347 (58·1 per cent) had laparoscopic resections. Meta‐analysis of adequacy of the mesorectal excision showed a small difference in achieving an intact mesorectum in favour of open surgery (risk ratio (RR) 1·06, 95 per cent c.i. 1·02 to 1·10;
Small differences in mesorectal quality were evident between open and laparoscopic rectal resections. This may be attributable to use of laparoscopic instruments; however, to date minor defects have not affected oncological outcomes.Full text
You may also be interested in
Authors: M. T. Adil, V. Jain, F. Rashid, O. Al‐taan, D. Whitelaw, P. Jambulingam et al.
Notes: Bariatric surgery improves physical function
Authors: B.‐H. Min, M. Hong, J. H. Lee, P.‐L. Rhee, T. S. Sohn, S. Kim et al.
Nomogram to predict lymph node metastasis in patients with early oesophageal squamous cell carcinoma.
Authors: H. Zheng, H. Tang, H. Wang, Y. Fang, Y. Shen, M. Feng et al.
Notes: Selecting patients for surgery or endoscopic treatment
Predictive value of abdominal CT in evaluating internal herniation after bariatric laparoscopic Roux‐en‐Y gastric bypass.
Authors: J. C. Ederveen, M. M. G. van Berckel, S. W. Nienhuijs, R. J. P. Weber, J. Nederend
Notes: Important tool for correct diagnosis
Authors: M. Kanda, D. Shimizu, H. Tanaka, C. Tanaka, D. Kobayashi, M. Hayashi et al.
Notes: Potential target for therapy
Development and validation of a difficulty score to predict intraoperative complications during laparoscopic liver resection.
Authors: M. C. Halls, G. Berardi, F. Cipriani, L. Barkhatov, P. Lainas, S. Harris et al.
Notes: Helps improve selection for laparoscopic liver resection
Authors: D. Zeng, R. Zhou, Y. Yu, Y. Luo, J. Zhang, H. Sun et al.
Notes: Immunoscore predicts prognosis in gastric cancer
Reappraisal of classification of distal cholangiocarcinoma based on tumour depth. BJS 2018; 105: 867-875.
Authors: H. Aoyama, T. Ebata, M. Hattori, M. Takano, H. Yamamoto, M. Inoue et al.
Notes: Better for T staging
Authors: S. D. Nelen, K. Bosscha, V. E. P. P. Lemmens, H. H. Hartgrink, R. H. A. Verhoeven, J. H. W. de Wilt et al.
Notes: Age does not matter
Prediction of major complications after hepatectomy using liver stiffness values determined by magnetic resonance elastography.
Authors: N. Sato, A. Kenjo, T. Kimura, R. Okada, T. Ishigame, Y. Kofunato et al.
Notes: liver stiffness predicts complications
Nationwide trends in the incidence and outcome of patients with gastrointestinal stromal tumour in the imatinib era. BJS 2018; 105: 1020-1027.
Authors: W. T. A. van der Graaf, R. Tielen, J. J. Bonenkamp, V. Lemmens, R. H. A. Verhoeven, J. H. W. de Wilt et al.
Notes: Surgery improves survival