Erschienen in:
01.04.2014 | Original Article
Laparoscopic Total Mesorectal Excision for Extraperitoneal Rectal Cancer: Long-Term Results of a 18-Year Single-Centre Experience
verfasst von:
Riccardo Brachet Contul, Manuela Grivon, Massimiliano Fabozzi, Paolo Millo, Mario Junior Nardi, Stefania Aimonetto, Umberto Parini, Rosaldo Allieta
Erschienen in:
Journal of Gastrointestinal Surgery
|
Ausgabe 4/2014
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Abstract
Background and Objectives
The oncologic efficacy of laparoscopic total mesorectal excision (TME) for middle–low rectal cancer is still under discussion because of the few long-term data. This study reports the results arising from a single-institution experience during a 18-year period.
Methods
Data about 132 consecutive laparoscopic TME performed between January 1994 and January 2012 were analysed with Kaplan–Meier method and a uni- and multi-variate analysis was conducted to define independent survival predictors.
Results
A total of 116 sphincter-preserving operations and 16 abdominoperineal resections were performed. Postoperative mortality and morbidity were 0.8 and 18.2 %, with a rate of anastomotic leakage of 13.8 %. Average follow-up was 85.9 months (range 13–210). Actuarial local recurrence rate was 4.13 % at 5 years (any pelvic recurrence developed after 3 years from surgery). Overall and disease-free survival was respectively 83 and 79.8 % at 5 years, 71 and 73 % at 10 years and then remained constant until 18 years. Survival was correlated only to tumour stage and the type of surgery.
Conclusions
Laparoscopic TME for extraperitoneal rectal cancer shows long-term oncologic outcomes similar to open rectal resections.