Current status of laparoscopic surgery for rectal carcinoma – our experience

Authors: L. Martínek;  J. Dostalík;  P. Guňková;  I. Guňka;  P. Vávra
Authors‘ workplace: Chirurgická klinika Fakultní nemocnice Ostrava ;  Přednosta: doc. MUDr. Jan Dostalík, CSc.
Published in: Prakt. Lék. 2009; 89(11): 628-632
Category: In diferent


Objective assessment of laparoscopic surgical technique in the therapy of rectal carcinoma.

Material and methods:
The study included a set of 196 patients who underwent elective surgery for rectal cancer using either laparoscopic or open techniques at the Department of Surgery, University Hospital Ostrava from the 1st of January 2001, to the 31st of December 2006. It was a unicentric, comparative, non-randomized prospective clinical study. The main objective was to compare both short-term results (represented by morbidity and mortality) and long-term results (represented by five-year overall survival).

Of the postoperative complications, except for a lower incidence of neurological complications in the laparoscopic group ( p = 0,0367), there was no difference in frequency of surgical and non-surgical complications. No difference was shown in morbidity (43 % open group vs. 39 % laparoscopic group), mortality (4 % in both open and laparoscopic groups). Overall five-year survival with open and laparoscopic surgery for all patients was 46 % and 55 % respectively, curative operations 60 % and 75 % respectively, stage I 88 % and 86 % respectively, stage II 87 % and 83 % respectively, stage III 41 % vs. 72 %, stage IV 0 % in both groups.

Except for significantly better five-year overall survival in the group of patients with laparoscopic technique and stage III (p = 0.0381), we reported no difference in long-term overall survival with the surgical techniques being compared.

The same results, i.e. no difference in long-term overall survival, with significantly better long-term overall survival in the laparoscopic group of patients and stage III (p = 0.01677), were obtained by analysis of cumulative survival curves.

Laparoscopic surgery of rectal carcinoma has the potential for improving the short-term results without discrediting long-term oncological results.

Key words:
rectal cancer, laparoscopy, outcomes.


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