[Safety of Laparoscopic Surgery after Preoperative Short Course Radiotherapy for Lower Rectal Cancer].

BACKGROUNDS: In the setting of routine use of preoperative chemoradiotherapy(CRT)for cStage II / III rectal cancer, shortcourse radiotherapy(short-RT)is selectively used for reducing local recurrence.The purpose of this study is to clarify the safety of laparoscopic surgery after preoperative short-RT for lower rectal cancer.

METHODS: Twenty-eight patients who un- derwent short-RT followed by laparoscopic total mesorectal excision for cStage II / III lower rectal cancer were retrospectively analyzed.

RESULTS: The reasons for selecting short-RT included comorbidity(n=10), refusal of CRT(n=8), multiple cancers (n=6)and others(n=4).All patients completed planned dose of radiation without severe acute toxicity.Median interval from completion of short-RT to surgery was 17 days(range 7-58).All patients underwent laparoscopic surgery without conversion to open surgery.Median operation time, blood loss and the number of dissected lymph nodes were 379 minutes (range 175-890), 90mL(range 0-1,185)and 27(range 12-71), respectively.Grade 3-4 complications occurred in 3 cases (10.7%).There were 2 cases with pathological complete response.

CONCLUSIONS: Laparoscopic surgery for lower rectal cancer after short-RT is safe and feasible.