Evaluating the short-term outcome of laparoscopic pelvic exenteration in locally advanced and recurrent rectal cancer.

PURPOSE

Pelvic exenteration (PE) is sometimes the only curative option for primary rectal cancer as well as locally recurrent rectal cancer (LRRC). However, data on laparoscopic PE (Lap-PE) for LRRC are limited. This study aimed to evaluate the technical safety of Lap-PE in LRRC cases.

METHODS

We retrospectively analyzed 63 patients who underwent Lap-PE between January 2013 and December 2023. Patients were categorized into primary (n = 41) and recurrent (n = 22) groups, and short-term outcomes, including operative details and postoperative complications, were compared.

RESULTS

The recurrent group had a significantly higher number of cases of multiple organs resected beyond PE (24.4% vs. 63.6%, p = 0.001). There were no significant differences in the operative time (714 vs. 633 min, p = 0.91) or blood loss (650 vs. 580 g, p = 0.98) between the groups. Clavien-Dindo Grade 3 complications occurred in 29.3% of primary cases and 18.2% of recurrent cases (p = 0.47). R0 resection was achieved in 95.1% of primary cases and 81.8% of recurrent cases (p = 0.10).

CONCLUSION

Lap PE for LRRC, when performed by an experienced laparoscopic surgical team with careful patient selection, was shown to be safe, with comparable short-term outcomes to those of PE for primary rectal cancer and an acceptable R0 resection rate.