Effect of preoperative chemoradiotherapy on perioperative outcomes in patients undergoing laparoscopic rectal cancer surgery

INTRODUCTION: The aim of this study was to investigate the effect of neoadjuvant chemoradiotherapy (nCRT) on perioperative outcomes in patients who underwent laparoscopic rectal cancer surgery.
METHODS: This retrospective study included patients who underwent laparoscopic surgery due to rectal adenocarcinoma between January 2017 and March 2019. Patients who underwent open surgery, transanal excision, or additional resection due to metastasis were excluded from the study. Demographic, clinical, and pathological characteristics of the patients were recorded. Perioperative complications were categorized according to the extended Clavien-Dindo classification.
RESULTS: The 61 patients enrolled in the study comprised 35 (57.4%) patients who received nCRT (nCRT group) and 26 (42.6%) patients who did not receive nCRT (non-nCRT group). The mean age was 54.6±12.9 years in the nCRT group and 62±14.8 years in the non-nCRT group, which represented a significant difference between the 2 groups (p=0.048). The groups were similar with regard to comorbidities, body mass index, American Society of Anesthesiologists score, pathological staging, and length of hospital stay. The mean operative time was 298±36.8 minutes in the nCRT group and 243±50.2 minutes in the non-nCRT group, which amounted to a significant difference (p<0.001). The classification of complications indicated Grade I, II, III, and IV complications in 16 (45.7%), 15 (42.8%), 3 (8.6%), and 1 (2.9%) patients, respectively, in the nCRT group as opposed to 16 (61.6%), 8 (30.8%), 1 (3.8%), and 1 (3.8%), respectively, in the non-nCRT group, and no significant difference was found between the 2 groups (p=0.606).

DISCUSSION AND CONCLUSION: The results indicated that nCRT had no effect on perioperative complications and resulted in longer operative times in laparoscopic rectal cancer surgery.