Laparoscopic versus open surgery for rectal neuroendocrine tumors: a multicenter real-world study
Xinyu Zeng,
Chengguo Li,
Minhao Yu,
Rui Zhang,
Guole Lin,
Maojun Di,
Hongxue Wu,
Yueming Sun,
Zhiguo Xiong,
Congqing Jiang,
Bin Yu,
Shengning Zhou,
Yong Li,
Xiaofeng Liao,
Lijian Xia,
Wei Zhang,
Weizhong Jiang,
Kaixiong Tao
Affiliations
Xinyu Zeng
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Chengguo Li
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Minhao Yu
Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University
Rui Zhang
Department of Colorectal Cancer, Liaoning Cancer Hospital & Institute
Guole Lin
Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences
Maojun Di
Department of Gastrointestinal Surgery, Taihe Hospital, Hubei University of Medicine
Hongxue Wu
Department of Gastrointestinal Surgery I Section, Renmin Hospital of Wuhan University
Yueming Sun
Department of Colorectal Surgery, Jiangsu Province Hospital, Nanjing Medical University
Zhiguo Xiong
Department of Gastrointestinal Surgery, Tongji Medical College, Hubei Cancer Hospital, Huazhong University of Science and Technology
Congqing Jiang
Department of Colorectal and Anal Surgery, Zhongnan Hospital of Wuhan University
Bin Yu
Department of General Surgery, Hebei Medical University Fourth Affiliated Hospital, Hebei Provincial Tumor Hospital
Shengning Zhou
Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University
Yong Li
Department of Gastrointestinal Surgery, Department of General Surgery, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University
Xiaofeng Liao
Department of General Surgery, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science
Lijian Xia
Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Shandong First Medical University
Wei Zhang
Department of Colorectal Surgery, Shanghai Changhai Hospital, Naval Medical University
Weizhong Jiang
Department of Colorectal Surgery, Fujian Medical University Union Hospital
Kaixiong Tao
Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
Abstract Background Owing to the lack of evidence-based medical studies with large sample sizes, the surgical approach for the radical resection of rectal neuroendocrine tumors remains controversial. Methods We retrospectively collected the medical records of patients with rectal neuroendocrine tumors who underwent radical resection at 17 large tertiary care hospitals in China between January 1, 2010, and April 30, 2022. All patients were divided into laparoscopic and open surgery groups. After propensity score matching to reduce confounders, the postoperative and oncologic outcomes were compared between the groups. Results We enrolled 174 patients with rectal neuroendocrine tumors who underwent radical surgery. After random matching, 124 patients were included in the comparison (62, laparoscopic surgery group; 62, open surgery group). The laparoscopic surgery group had fewer complications (14.5% vs. 35.5%, P = 0.007) and superior relapse-free survival (P = 0.048). Subgroup analysis revealed that the laparoscopic surgery group had fewer complications (10.9% vs. 34.7%, P = 0.004), shorter postoperative hospital stays (9.56 ± 5.21 days vs. 12.31 ± 8.61 days, P = 0.049) and superior relapse-free survival (P = 0.025) in the rectal neuroendocrine tumors ≤ 4 cm subgroup. Conclusions Laparoscopic surgery was associated with improved postoperative outcomes and oncologic prognosis for patients with rectal neuroendocrine tumors ≤ 4 cm; it can serve as a safe and feasible option for radical surgery of rectal neuroendocrine tumors.
