Annals of Surgery 2012/05/28 CRS related topics

Annals of Surgery: May 2012 - Volume 255 - Issue 5 - p 922–928

Post-LAR syndrome: incontinence, urgency, and frequent bowel movements

Risk factors（Higher LARS score):
with radiotherapy (P < 0.0001), tumor height less than 5 cm (P < 0.0001), and total mesorectal excision (P = 0.0163).

Evaluated by LAR symdrome score

Over 30: Major LAR symptoms(+)==> 影響生活!

Annals of Surgery : Volume 255(5), May 2012, p 929–934Open Versus Laparoscopic Resection of Primary Tumor for Incurable Stage IV Colorectal Cancer: A Large Multicenter Consecutive Patients Cohort Study

Methods: exclusion of any curative surgery!!

1. The complication rate after laparoscopic surgery (17%) was significantly lower than that after open surgery (24%) (P = 0.02),
the difference was greater (4% vs 12%; P < 0.001)  to severe (>=grade 3) complications

2. Laparoscopic surgery significantly lower hospital stay than that for open surgery (14 vs 17 days; P = 0.002)

3. Univariate: laparoscopic group was significantly better than that for open surgery (median survival time: 25.9 vs 22.3 months, P = 0.04)



Major risk factors of Survival: Tumor related factors(R2 organ, CEA, age)



Conclusion:Laparoscopic surgery in palliative surgery has advantages in the short term and no disadvantages in the long term.

Annals of Surgery: POST AUTHOR CORRECTIONS, 11 May 2012
doi: 10.1097/SLA.0b013e318257d2c1

Anastomotic Leak Is Not Associated With Oncologic Outcome in Patients Undergoing Low Anterior Resection for Rectal Cancer

Methods:
low anterior resection (1991-2010) for rectal adenocarcinoma (<=15 cm from anal verge) were retrospectively analyzed

Conclusion:
anastomotic leakage was not associated with risk of local recurrence.
Defunctioning stoma was associated with lower incidence of clinical leakage (2.2% vs. 6.3%, p=0.05) but not with difference in oncologic outcome.