期刊
DIGESTIVE SURGERY
卷 30, 期 4-6, 页码 317-327出版社
KARGER
DOI: 10.1159/000354580
关键词
Colon cancer; Surgery; Laparoscopy; Complications.; Oncological outcome
资金
- Western Norway Regional Health Authority
- University of Bergen
- Research Fund at Haraldsplass Deaconess Hospital
Background:Complete mesocolic excision (CME) and a high (apical) vascular tie may improve oncologic outcome after surgery for colon cancer. Our primary aim was to emulate a previous national result of 73.8% overall survival (OS) with both the open and laparoscopic techniques. Methods: A prospective study of radical colon cancer was initiated in a Norwegian community teaching hospital in 2007 and comprised a consecutive group of 251 patients with TNM stages I Ill that had surgery according to the CME principle. Oncological outcome was assessed as OS, disease-free survival (DES) and cancer-specific survival (CSS), as well as time to recurrence (TTR), using Cox regression analysis. Results: Inhospital mortality was 3.6%, 2.3% for laparoscopic surgery and 4.9% for open management. Significantly more patients in the open CME group developed complications in the short term (p < 0.001). Twelve or more lymph nodes were retrieved from 82.9% (208/251) of the specimens. Overall 3-year OS was 84.5%, DFS 77.4%, CSS 91.5% and TTR 86.8%. The surgical approach was not a significant predictor for any of the survival parameters. Conclusions:There was no survival difference between open and laparoscopic CME colonic resections, and the present OS improved from a previous OS from 2000. (C) 2013 S. Karger AG, Basel
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