Outcomes in rectal cancer patients undergoing laparoscopic or robotic low anterior resection compared to open: a propens
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and Other Interventional Techniques
Outcomes in rectal cancer patients undergoing laparoscopic or robotic low anterior resection compared to open: a propensity‑matched analysis of the NCDB (2010–2015) Brandon C. Chapman1,3 · Mark Edgcomb2 · Ana Gleisner1 · Jon D. Vogel1 Received: 22 May 2019 / Accepted: 8 November 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Background Minimally invasive resection of rectal cancer is controversial due to concerns of the oncologic efficacy and the difficulties of a laparoscopic total mesorectal excision (TME). Methods Using the National Cancer Database (NCDB), for the period 2010–2015, perioperative outcomes and overall survival (OS) in patients with rectal cancer who underwent laparoscopic or robotic low anterior resection (LLAR or RLAR) were compared to open LAR (OLAR) after propensity score matching. Results 26,047 patients underwent LAR: 4062 (16%) RLAR, 9236 (35%) LLAR, and 12,749 (49%) OLAR. Patient and clinical tumor characteristics were similar between groups after matching. The conversion rates among patients undergoing LLAR and RLAR were 15% and 8%, respectively. In matched OLAR and LLAR patients, longitudinal and circumferential resection margins (CRM) were positive in 5.4% and 3.2% (p
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