Laparoscopic surgery for the cure of colorectal cancer: results of a German five-center study

The aim of this study was to assess the feasibility and safety of laparoscopic surgery for the cure of colorectal cancer with emphasis on oncologic follow-up in particular. A study was performed of patients with colorectal cancer treated by laparoscopy in five German centers between May 1991 and Sep...

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Bibliographic Details
Published in:	Diseases of the colon & rectum Vol. 43; no. 1; p. 1
Main Authors:	Schiedeck, T H, Schwandner, O, Baca, I, Baehrlehner, E, Konradt, J, Köckerling, F, Kuthe, A, Buerk, C, Herold, A, Bruch, H P
Format:	Journal Article
Language:	English
Published:	United States 01-01-2000
Subjects:	Abdomen - surgery Aged Analgesics - therapeutic use Colectomy - adverse effects Colectomy - classification Colon, Sigmoid - surgery Colonic Neoplasms - pathology Colonic Neoplasms - surgery Databases as Topic Defecation - physiology Feasibility Studies Female Follow-Up Studies Germany Humans Laparoscopy - adverse effects Laparoscopy - classification Length of Stay Lymph Node Excision Male Middle Aged Neoplasm Recurrence, Local - pathology Neoplasm Seeding Neoplasm Staging Perineum - surgery Rectal Neoplasms - pathology Rectal Neoplasms - surgery Registries Reoperation Safety Survival Rate Germany
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Summary:	The aim of this study was to assess the feasibility and safety of laparoscopic surgery for the cure of colorectal cancer with emphasis on oncologic follow-up in particular. A study was performed of patients with colorectal cancer treated by laparoscopy in five German centers between May 1991 and September 1997. Surgical and pathologic data were recorded in an anonymous registry database and analyzed by type of resection. Standard procedures were sigmoid or left colectomy, anterior resection, abdominoperineal resection, and right hemicolectomy. Follow-up information included incidence of local, distant, and port site recurrence and cancer-related death. A total of 399 patients (212 females) with a mean age of 66.6 years underwent laparoscopic curative resections (sigmoid resection, 89; left colectomy, 11; anterior resection, 157; abdominoperineal resection, 102; right hemicolectomy, 40). Conversion was necessary in 6.3 percent (n = 25). Complications requiring reoperation occurred in 9 percent (n = 35). Complications that were treated conservatively occurred in 27.6 percent (n = 110). Thirty-day mortality was 1.8 percent (n = 7). First bowel movements resumed on the third postoperative day; patients did not use analgesics after a mean of five days. Mean postoperative hospitalization was two weeks. According to International Union Against Cancer classification, 147 patients had Stage I cancer, 35 had Stage II cancer, and 217 underwent curative resection for Stage III cancer. Mean number of lymph nodes resected was 12.1. At a mean follow-up of 30 months, one port site recurrence was documented. No local recurrence was observed after curative resection of Stage I colorectal cancer. Of 399 patients, local recurrence occurred in 6 patients (Stage II, 2; Stage III, 4), and distant metastases were documented in 25 patients (Stage I, 3; Stage II, 3; Stage III, 19). The highest incidence of cancer-related death occurred after abdominoperineal resection (4.9 percent). To assess the role of laparoscopic colorectal surgery for the cure of cancer objectively, prospective randomized trials are necessary.
ISSN:	0012-3706
DOI:	10.1007/BF02237235