ArticleBJS open2021
Minimally invasive versus open pelvic exenterations for rectal cancer: a comparative analysis of perioperative and 3-year oncological outcomes.
Article in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 40 citations in OpenAlex.
- R0 Resection Rates in Minimally Invasive Versus Open Pelvic Exenteration for Colorectal Malignancies: A Systematic Review and Meta-Analysis.Journal of surgical oncology · 2025Pooled it
- Short- and long-term outcomes of minimally invasive vs. open pelvic exenteration in rectal tumours: a focused meta-analysis.International journal of colorectal disease · 2025Pooled it
- Tumour immune microenvironment prognostic factors in locally advanced rectal cancer, a systematic review.Frontiers in oncology · 2025Pooled it
- Robotic-assisted versus laparoscopic bowel anastomoses: randomized crossover in vivo experimental study.Surgical endoscopy · 2023Trial
- Clinical Implementation and Perioperative Outcomes of Robot-Assisted Pelvic Exenteration for Primary Rectal Cancer: A Multicenter Japanese Experience.Annals of gastroenterological surgery · 2026Article
- Review
- Propensity-score matched outcomes of minimally invasive and open pelvic exenteration in locally advanced rectal cancer.Updates in surgery · 2025Article
- Minimally invasive multivisceral resection in rectal cancer: Preparation or Precipitation?World journal of gastrointestinal surgery · 2024Article
- Robotic versus open and laparoscopic pelvic exenterations for pelvic cancer: a multicenter propensity-matched analysis in Japan.Surgical endoscopy · 2024Article
- Minimally invasive versus open multivisceral resection for rectal cancer clinically invading adjacent organs: a propensity score-matched analysis.Surgical endoscopy · 2024Article
- A novel classification of posterior pelvic exenteration to assess prognosis in female patients with locally advanced primary rectal cancer: a retrospective cohort study from China PelvEx collaborative.International journal of colorectal disease · 2024Article
- Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer: A 9-year review.World journal of gastrointestinal surgery · 2024Article
- Current status of robot-assisted total pelvic exenteration focusing on the field of urology: a clinical practice review.Translational cancer research · 2024Review
- The impact of staple transection of the dorsal venous complex and urethra on intraoperative blood loss in cooperative laparoscopic and transperineal endoscopic pelvic exenteration.Surgery today · 2024Article
- Simultaneous resection of synchronous colorectal liver metastasis: Feasibility and development of a prediction model.Annals of hepato-biliary-pancreatic surgery · 2023Article
- Minimally invasive surgery for maximally invasive tumors: pelvic exenterations for rectal cancers.Journal of minimally invasive surgery · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThis study compared the surgical and oncological outcomes of open and minimally invasive pelvic exenteration.
methodsPatients who underwent pelvic exenterations for primary locally advanced rectal cancers with invasion of the urogenital organs (central and anterior disease) between August 2013 and September 2020 were reviewed retrospectively. Patients were categorized as undergoing open or minimally invasive surgery (MIS) and these groups were compared for perioperative outcomes and 3-year survival (overall, recurrence-free and local relapse-free survival). Multivariable Cox regression analysis was performed to assess the independent influence of approach of surgery and cancer features on recurrence-free survival (RFS).
resultsOf the 158 patients who underwent pelvic exenteration, 97 (61.4 per cent) had open exenterations and 61 (38.6 per cent) patients had an MIS resection (44 patients (72 per cent) using laparoscopy and 17 (28 per cent) using robotic surgery). There were 96 (60.8 per cent) total pelvic exenterations and 62 (39.2 per cent) posterior pelvic exenterations. MIS exenterations had significantly longer operative times (MIS versus open: 640 mins versus 450 mins; P < 0.001) but reduced blood loss (MIS versus open: 900 ml versus 1600 ml; P < 0.001) and abdominal wound infections (MIS versus open: 8.2 versus 17.5 per cent; P = 0.020) without a difference in hospital stay (MIS versus open: 11 versus 12 days; P = 0.620). R0 resection rates and involvement of circumferential resection margins were similar (MIS versus open: 88.5 versus 91.8 per cent, P = 0.490 and 13.1 versus 8.2 per cent, P = 0.342 respectively). At a median follow-up of 29 months, there were no differences in 3-year overall survival (MIS versus open: 79.4 versus 60.2 per cent; P = 0.251), RFS (MIS versus open: 51.9 versus 47.8 per cent; P = 0.922) or local relapse-free survival (MIS versus open: 89.7 versus 75.2 per cent; P = 0.491. On multivariable analysis, approach to surgery had no bearing on RFS, and only known distant metastasis, aggressive histology and inadequate response to neoadjuvant radiation (pathological tumour regression grade greater than 3) predicted worse RFS.
conclusionMIS exenterations documented longer procedures but resulted in less blood loss and fewer wound infections compared with open surgeries. In the setting of an experienced centre, the hospital stay, R0 resection rates and oncological outcomes at 3 years were similar to those of open exenterations.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.