Laparoscopic Wide Mesocolic Excision and Central Vascular Ligation for Carcinoma of the Colon
| Autor: | A. Ehrlich, M. Kairaluoma, Hannu Kautiainen, J. Böhm, I. Kellokumpu, K. Vasala |
|---|---|
| Přispěvatelé: | Department of General Practice and Primary Health Care, Clinicum |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Colorectal cancer education medicine.disease 3126 Surgery anesthesiology intensive care radiology 3. Good health Surgery 03 medical and health sciences 0302 clinical medicine Text mining 030220 oncology & carcinogenesis medicine Carcinoma Multimodal treatment 030211 gastroenterology & hepatology business Ligation Laparoscopy |
| Zdroj: | Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society. 105(4) |
| ISSN: | 1799-7267 |
| Popis: | Background and Aims: The principle of complete mesocolic excision for colon cancer has been introduced to improve oncologic outcome. However, this approach is scantily discussed for laparoscopic surgery and there is a lack of randomized trials. This study examined oncologic and clinical outcome after laparoscopic wide mesocolic excision and central vascular ligation for colon cancer. Material and Methods: This is a review of prospectively gathered data from a single-institution colorectal cancer database. This study was conducted in the Central Hospital of Central Finland. From January 2003 to December 2011, 222 patients underwent laparoscopic colonic resections with wide mesocolic excision and central vascular ligation in the multimodal setting. The main measures of outcome were cancer recurrence and survival, with early recovery, 30d-mortality and morbidity, reoperation, readmission, and late complications as secondary outcomes. Results: The median follow-up was 5.5 (interquartile range (IQR) = 3.7–8.0) years. The 5-year overall survival for all 222 patients was 80.2% and disease-specific survival was 87.5%, and for those 210 R0-patients with stage I–III disease, 83.9% and 91.3%, respectively. The 5-year disease-free survival was 85.8%: stage I was 94.7%, stage II was 90.8%, and stage III was 75.6% ( p = 0.004). Increasing lymph node ratio significantly decreased the 5-year disease-free survival. Conversion rate to open surgery was 12.2%. Thirty-day mortality was 1.3% and morbidity, 19.7%. Median postoperative hospital stay was 5 (IQR = 3–7) days. Conclusion: Laparoscopic wide mesocolic excision and central vascular ligation for colon cancer resulted in good long-term oncologic outcome. Randomized trials are needed to show that laparoscopic complete mesocolic excision technique would become the standard of care for the carcinoma of the colon. |
| Databáze: | OpenAIRE |
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