Laparoscopic total mesorectal excision for rectal cancer: is it the predictive factor for incomplete mesorectal excision?

摘要

We have read with great interest the article by Leonard et al, who examined preoperative tumor-, patient-, and treatment-related factors that are independently associated with incomplete total mesorectal excision (TME) specimens. Their study was based on anonymously reviewed material from 266 consecutive TME specimens submitted by 33 candidate TME tutors in the context of PROCARE, a Belgian multidisci-plinary project on rectal cancer. They showed that pathologic body mass index, the absence of downstaging after long-course chemoradi-ation, and laparoscopic or converted laparo-scopic resection were significantly associated with incomplete mesorectal excision using multivariate analysis. Although their work is excellent, there is a major point that needs further discussion to conclude that laparoscopic resection is independently associated with incomplete TME.