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LONG-TERM OUTCOME OF LAPAROSCOPIC SURGERY FOR COLORECTAL CANCERS

Authors


Chou-Chen Chen, Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 160 Sec 3, Chung-Kang Road, Taichung, Taiwan. Email: ccchen407@yahoo.com.tw

Abstract

There are three types of laparoscopic surgery for colorectal disease, medial-to-lateral, lateral-to-medial and the retroperitoneal laparoscopic approach. The purpose of the present study is to evaluate the long-term results of laparoscopic colectomy for colorectal cancer by the transabdominal and retroperitoneal laparoscopic approaches, to provide current status of clinical outcomes of laparoscopic surgery including acceptable ranges of complications, morbidity and survival rate. Many transabdominal operations have been reported the clinical outcomes either one surgical team or multiple center series in recent decades. However, only one journal reported retroperitoneal laparoscopic surgery, including data of 309 patients at Sakura National Hospital from June 1994 to March 2003. Ten cases (3.2%) were converted to open colectomy and nine of these were in the first 100 cases (1.9%) compared with only one within the other 209 patients (0.47%), this being within a reasonable range 0%−3.2%. There were no port site recurrences. Eight patients had lung and/or liver metastases and died of disease. The average survival time was 28.4 months. The 5-year survival rates were 100%, 89.7%, 85.5% and 72.9% for stages I, II, IIIa and IIIb, respectively. In a literature review of journals for laparoscopic surgery for colorectal cancers, the conversion rate is variable from 0 to 17%, and the local recurrence rate is generally usually below 6.8%. The 5-year survival rates are approximately 97-89%, 88-78% and 67-59% for stages I, II and III, respectively.

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