Laparoscopic sphincter‐preserving total mesorectal excision: 10‐year report

Aim Total mesorectal excision (TME) is currently the gold standard for resection of mid or low rectal cancer and is associated with a low local recurrence rate. However, few studies have reported the long‐term oncological outcome following use of a laparoscopic approach. The aim of this study was to evaluate the long‐term oncological outcome after laparoscopic sphincter‐preserving TME with a median follow up of about 4 years. Method Patients with mid or low rectal cancer who underwent laparoscopic sphincter‐preserving TME with curative intent between March 1999 and March 2009 were prospectively recruited for analysis. Results During the 10‐year study period, 177 patients underwent laparoscopic sphincter‐preserving TME with curative intent for rectal cancer. Conversion was required in two (1%) patients. There was no operative mortality. At a median follow‐up period of 49 months, local recurrence had occurred in nine (5.1%) patients. The overall metastatic recurrence rate after curative resection was 22%. The overall 5‐year survival and 5‐year disease‐free survival in the present study were 74% and 71%, respectively. Conclusion The results of this study show that laparoscopic sphincter‐preserving TME is safe with long‐term oncological outcomes comparable to those of open surgery.