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306
LAPAROSCOPIC COLORECTAL PROCEDURES: SHORT-TERM AND ONCOLOGICAL LONG-TERM
RESULTS
Danny Rosin, Oded Zmora, Aviad Hoffman, Marat Khaikin,
Barak Bar Zakai,
Yaron Munz, Moshe Shabtai, Amram Ayalon
The Department of General
Surgery & Transplantation, Sheba Medical Center, Tel Hashomer, Sackler
School of Medicine, Tel Aviv
Background:
Laparoscopic surgery has recently gained wide acceptance in the treatment
of colorectal pathologies, including cancer. Long-term outcome however
requires further assessment. The aim of this study is to evaluate short and
long term outcomes after 8 years of performing laparoscopic colon and
rectal surgery.
Methods: Data relative to all
patients who underwent laparoscopic colon and rectal surgery in our
department was prospectively recorded. Demographics, operative procedure,
post-operative course, oncologic treatment and follow-up data were reviewed
in this study. Survival was calculated for patients with cancer who
completed at least 3 years of follow-up.
Results: 306 procedures were
performed over a period of 8 years, 184 (60%) for malignancy and 122 (40%)
for benign conditions. The number of procedures stabilized at around 50 per
year, and included right colectomy (81), sigmoidectomy (80), Anterior
resection (55) and left colectomy (34), and other procedures (55).
Mean operating time was 243 minutes, and conversion rate was 14.7%.
Post-operative complications included wound infection in 16.9% and
anastomotic leak in 5.2% of the cases. Re-operation was required in 9.1%,
and overall post-operative mortality, including after emergency colorectal
procedures, was 3.2%.
For the group operated for cancer until 2001, actual 3-year survival for
all stages was 71%. Node-positive patients had 73% 3-year survival rate.
Conclusions: Laparoscopic
colorectal surgery allows for acceptable short term and oncologic outcome,
comparable to that achieved by open surgery.
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