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Hybrid minimally invasive/open approach versus total minimally invasive approach for rectal cancer resection: short- and long-term results

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objectives

To reduce the technical challenges of a totally minimally invasive approach (TMA) and to decrease the morbidity associated with open surgery, a hybrid minimally invasive/open approach (HMOA) has been introduced as a surgical technique for rectal cancer. The aim of this study was to compare postoperative results and long-term oncologic outcomes between hybrid minimally invasive/open approach and totally minimally invasive approach in patients who underwent rectal resection for cancer.

Methods

All patients with rectal cancer undergoing a totally minimally invasive approach or hybrid minimally invasive/open approach proctectomy between 2012 and 2016 were analyzed. Preoperative and postoperative outcomes were collected from a prospectively maintained institutional database.

Results

Among 283 patients, 138 (48.8%) underwent a hybrid minimally invasive/open approach and 145 (51.2%) a totally minimally invasive approach. Preoperative characteristics were similar between groups except for distance from the anal verge, which was lower in totally minimally invasive approach group (50.7% vs 29%; p = 0.0008). Length of stay (LOS) was significantly longer in the hybrid minimally invasive/open approach group (6.4 vs 4.3; p = < 0.0001). The median follow-up was 29.6 (14–40.6) months. Overall survival and disease-free survival were not significantly different between groups.

Conclusions

Compared with a hybrid minimally invasive/open approach, a totally minimally invasive approach has a shorter length of stay and may improve short-term outcomes in patients undergoing proctectomy for cancer.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Simona Deidda, Jacopo Crippa, Emilie Duchalais, Scott R. Kelley, Kellie L. Mathis, Eric J. Dozois & David W. Larson

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  1. Simona Deidda
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  2. Jacopo Crippa
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  3. Emilie Duchalais
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  4. Scott R. Kelley
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  7. David W. Larson
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Correspondence to David W. Larson.

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The Mayo Clinic Review Board approved this study. Mayo Clinic was the sole support for this study.

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The authors declare that they have no conflict of interest.

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Deidda, S., Crippa, J., Duchalais, E. et al. Hybrid minimally invasive/open approach versus total minimally invasive approach for rectal cancer resection: short- and long-term results. Int J Colorectal Dis 34, 1251–1258 (2019). https://doi.org/10.1007/s00384-019-03311-4

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  • DOI: https://doi.org/10.1007/s00384-019-03311-4

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