Risk factors for circumferential R1 resection after neoadjuvant radiochemotherapy and laparoscopic total mesorectal excision: a study in 233 consecutive patients with mid or low rectal cancer.

摘要: This study aimed to identify risk factors for circumferential R1 resection (R1c) after neoadjuvant radiochemotherapy (RCT) and laparoscopic total mesorectal excision (TME) mid or low rectal cancer. Better knowledge of pre- intraoperative could possibly help the management these patients. Between 2005 2013, 233 consecutive patients undergoing TME cancer RCT were included. R1c was defined as a margin ≤1 mm. Univariate multivariate analyses performed independent R1c. Twenty-five had (11 %). In univariate analysis, cancer, anterior tumour, T4 on pretherapeutic magnetic resonance imaging (MRI), and/or N+ post-RCT MRI operative time >240 min associated with significantly increased resection. only (odds ratio (OR) = 6.02 [1.06–33]; p = 0.043) >240 min. (OR = 5.4 [1.01–28.9]; p = 0.049) identified The 3 % (n = 3/88), 10 % (n = 5/51) 38 % (n = 3/8) when 0, 1 2 present in same patient, respectively. Patients seems be at higher pragmatic approach, we consider that systematic second surgeon, especially area where is too short, order reduce this