Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes

Dis Colon Rectum. 2002 Jul;45(7):867-72; discussion 872-5. doi: 10.1007/s10350-004-6318-6.

Abstract

Purpose: Since 1991, a laparoscopic-assisted resection has been used at the Royal Brisbane Hospital selectively for patients with colorectal cancer. This article audits the intermediate to long-term postoperative complications and cancer follow-up data.

Methods: All patients undergoing a laparoscopic resection for cancer were prospectively followed up with regard to long-term outcomes.

Results: One hundred eighty-one patients have been studied. One hundred fifty-four patients had potentially curative procedures performed in the study period. Median follow up was 71 (range, 7-108) months. The overall recurrence rate in this group was 6 percent (21 recurrences). There was one port site recurrence after a potentially curative procedure (0.6 percent) and one port site recurrence after a palliative resection. Perioperative mortality was 1 percent (2 patients). Only six patients suffered an adhesive small-bowel obstruction postoperatively. There was one incisional hernia. Unadjusted five-year median survival data for Australian Clinico-pathological Staging A was 91 percent (3.5 percent recurrence); for Australian Clinico-pathological Staging B, 83 percent (15 percent recurrence); and for Australian Clinico-pathological Staging C, 74 percent (26 percent recurrence).

Conclusion: In selected patients a laparoscopic resection for colorectal cancer produces acceptable intermediate to long-term oncologic outcomes and a low long-term complication rate.

MeSH terms

  • Colectomy / adverse effects*
  • Colectomy / instrumentation
  • Colectomy / methods*
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Follow-Up Studies
  • Humans
  • Laparoscopy / adverse effects*
  • Medical Audit
  • Neoplasm Recurrence, Local*
  • Neoplasm Seeding*
  • Neoplasm Staging
  • Prospective Studies
  • Survival Analysis
  • Time Factors
  • Treatment Outcome