Evaluating the short-term outcome of laparoscopic pelvic exenteration in locally advanced and recurrent rectal cancer.

[PURPOSE] Pelvic exenteration (PE) is sometimes the only curative option for primary rectal cancer as well as locally recurrent rectal cancer (LRRC). However, data on laparoscopic PE (Lap-PE) for LRRC are limited. This study aimed to evaluate the technical safety of Lap-PE in LRRC cases.

[METHODS] We retrospectively analyzed 63 patients who underwent Lap-PE between January 2013 and December 2023. Patients were categorized into primary (n = 41) and recurrent (n = 22) groups, and short-term outcomes, including operative details and postoperative complications, were compared.

[RESULTS] The recurrent group had a significantly higher number of cases of multiple organs resected beyond PE (24.4% vs. 63.6%, p = 0.001). There were no significant differences in the operative time (714 vs. 633 min, p = 0.91) or blood loss (650 vs. 580 g, p = 0.98) between the groups. Clavien-Dindo Grade 3 complications occurred in 29.3% of primary cases and 18.2% of recurrent cases (p = 0.47). R0 resection was achieved in 95.1% of primary cases and 81.8% of recurrent cases (p = 0.10).

[CONCLUSION] Lap PE for LRRC, when performed by an experienced laparoscopic surgical team with careful patient selection, was shown to be safe, with comparable short-term outcomes to those of PE for primary rectal cancer and an acceptable R0 resection rate.