Skip to main content
Erschienen in: Surgical Endoscopy 10/2008

01.10.2008

Laparoscopic surgery for rectal cancer: oncological results and clinical outcome of 225 patients

verfasst von: Ayman Agha, Alois Fürst, Johanna Hierl, Igors Iesalnieks, Gabriel Glockzin, Matthias Anthuber, Karl-Walter Jauch, Hans J. Schlitt

Erschienen in: Surgical Endoscopy | Ausgabe 10/2008

Einloggen, um Zugang zu erhalten

Abstract

Introduction

The efficacy and feasibility of laparoscopic resection for rectal cancer has been proved, but the results of prospective, randomized studies are not yet available. Here we present a prospective observational study evaluating oncological and clinical outcome after laparoscopic surgery in patients with rectal cancer.

Patients and Methods

Between January 1998 and March 2005, 225 patients with rectal adenocarcinoma underwent laparoscopic surgery at the University of Regensburg Medical Center. Clinical and oncological outcome of these patients including perioperative and long-term complications was evaluated. Survival curves were calculated according to the Kaplan–Meier method. Minimum follow-up was 24 months.

Results

The distribution of the International Union against Cancer (UICC) stages was: 37.7% stage I, 20.5% stage II, 24.9% stage III, and 16.9% stage IV. Local recurrence was diagnosed in 5.8% and distant metastases in 8.1% of cases after mean follow-up of 36.4 months. The 5-year overall survival rate was 75.7% after curative and 40.7% after palliative surgery (p < 0.05). The stage-related survival rates were 86.7% for UICC stage I, 61.7% for stage II, 68.1% for stage III, and 40.1% for stage IV.

Conclusions

Our results demonstrate the efficacy and technical feasibility of laparoscopic surgery for rectal cancer regarding the perioperative morbidity and the oncological outcome.
Literatur
1.
Zurück zum Zitat Anthuber M, Fuerst A, Elser F, Berger R, Jauch KW (2003) Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 46:1047–1053PubMedCrossRef Anthuber M, Fuerst A, Elser F, Berger R, Jauch KW (2003) Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 46:1047–1053PubMedCrossRef
2.
Zurück zum Zitat Barlehner E, Benhidjeb T, Anders S, Schicke B (2005) Aktueller Stand der laparoskopischen Rektumresektion beim Karzinom. Chir Gastroenterol 21:54–61CrossRef Barlehner E, Benhidjeb T, Anders S, Schicke B (2005) Aktueller Stand der laparoskopischen Rektumresektion beim Karzinom. Chir Gastroenterol 21:54–61CrossRef
3.
Zurück zum Zitat Feliciotti F, Guerrieri M, Paganini AM, De Sanctis A, Campagnacci R, Perretta S, D’Ambrosio G, Lezoche E (2003) Long-term results of laparoscopic versus open resections for rectal cancer for 124 unselected patients. Surg Endosc 17:1530–1535PubMedCrossRef Feliciotti F, Guerrieri M, Paganini AM, De Sanctis A, Campagnacci R, Perretta S, D’Ambrosio G, Lezoche E (2003) Long-term results of laparoscopic versus open resections for rectal cancer for 124 unselected patients. Surg Endosc 17:1530–1535PubMedCrossRef
4.
Zurück zum Zitat Leroy J, Jamali F, Forbes L, Smith M, Rubino F, Mutter D, Marescaux J (2004) Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc 18:281–289PubMedCrossRef Leroy J, Jamali F, Forbes L, Smith M, Rubino F, Mutter D, Marescaux J (2004) Laparoscopic total mesorectal excision (TME) for rectal cancer surgery: long-term outcomes. Surg Endosc 18:281–289PubMedCrossRef
5.
Zurück zum Zitat Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363:1187–1192PubMedCrossRef Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363:1187–1192PubMedCrossRef
6.
Zurück zum Zitat Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P (1998) A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187:46–54; discussion 54–45 Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiger E, Elson P (1998) A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187:46–54; discussion 54–45
7.
Zurück zum Zitat Morino M, Parini U, Giraudo G, Salval M, Brachet Contul R, Garrone C (2003) Laparoscopic total mesorectal excision: a consecutive series of 100 patients. Ann Surg 237:335–342PubMedCrossRef Morino M, Parini U, Giraudo G, Salval M, Brachet Contul R, Garrone C (2003) Laparoscopic total mesorectal excision: a consecutive series of 100 patients. Ann Surg 237:335–342PubMedCrossRef
8.
Zurück zum Zitat Tang CL, Eu KW, Tai BC, Soh JG, MacHin D, Seow-Choen F (2001) Randomized clinical trial of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer. Br J Surg 88:801–807PubMedCrossRef Tang CL, Eu KW, Tai BC, Soh JG, MacHin D, Seow-Choen F (2001) Randomized clinical trial of the effect of open versus laparoscopically assisted colectomy on systemic immunity in patients with colorectal cancer. Br J Surg 88:801–807PubMedCrossRef
9.
Zurück zum Zitat Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef
10.
Zurück zum Zitat Bruch HP, Esnaashari H, Schwandner O (2005) Current status of laparoscopic therapy of colorectal cancer. Dig Dis 23:127–134PubMedCrossRef Bruch HP, Esnaashari H, Schwandner O (2005) Current status of laparoscopic therapy of colorectal cancer. Dig Dis 23:127–134PubMedCrossRef
11.
Zurück zum Zitat Breukink SO, Grond AJ, Pierie JP, Hoff C, Wiggers T, Meijerink WJ (2005) Laparoscopic vs open total mesorectal excision for rectal cancer: an evaluation of the mesorectum’s macroscopic quality. Surg Endosc 19:307–310PubMedCrossRef Breukink SO, Grond AJ, Pierie JP, Hoff C, Wiggers T, Meijerink WJ (2005) Laparoscopic vs open total mesorectal excision for rectal cancer: an evaluation of the mesorectum’s macroscopic quality. Surg Endosc 19:307–310PubMedCrossRef
12.
Zurück zum Zitat Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM (2005) Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365:1718–1726PubMedCrossRef
13.
Zurück zum Zitat Hartley JE, Mehigan BJ, Qureshi AE, Duthie GS, Lee PW, Monson JR (2001) Total mesorectal excision: assessment of the laparoscopic approach. Dis Colon Rectum 44:315–321PubMedCrossRef Hartley JE, Mehigan BJ, Qureshi AE, Duthie GS, Lee PW, Monson JR (2001) Total mesorectal excision: assessment of the laparoscopic approach. Dis Colon Rectum 44:315–321PubMedCrossRef
14.
Zurück zum Zitat Kockerling F, Scheidbach H, Schneider C, Barlehner E, Kohler L, Bruch HP, Konradt J, Wittekind C, Hohenberger W (2000) Laparoscopic abdominoperineal resection: early postoperative results of a prospective study involving 116 patients. The Laparoscopic Colorectal Surgery Study Group. Dis Colon Rectum 43:1503–1511PubMedCrossRef Kockerling F, Scheidbach H, Schneider C, Barlehner E, Kohler L, Bruch HP, Konradt J, Wittekind C, Hohenberger W (2000) Laparoscopic abdominoperineal resection: early postoperative results of a prospective study involving 116 patients. The Laparoscopic Colorectal Surgery Study Group. Dis Colon Rectum 43:1503–1511PubMedCrossRef
15.
Zurück zum Zitat Kockerling F, Reymond MA, Schneider C, Wittekind C, Scheidbach H, Konradt J, Kohler L, Barlehner E, Kuthe A, Bruch HP, Hohenberger W (1998) Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. The laparoscopic colorectal surgery study group. Dis Colon Rectum 41:963–970PubMedCrossRef Kockerling F, Reymond MA, Schneider C, Wittekind C, Scheidbach H, Konradt J, Kohler L, Barlehner E, Kuthe A, Bruch HP, Hohenberger W (1998) Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. The laparoscopic colorectal surgery study group. Dis Colon Rectum 41:963–970PubMedCrossRef
16.
Zurück zum Zitat Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRef Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229PubMedCrossRef
17.
Zurück zum Zitat Rullier E, Sa Cunha A, Couderc P, Rullier A, Gontier R, Saric J (2003) Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer. Br J Surg 90:445–451PubMedCrossRef Rullier E, Sa Cunha A, Couderc P, Rullier A, Gontier R, Saric J (2003) Laparoscopic intersphincteric resection with coloplasty and coloanal anastomosis for mid and low rectal cancer. Br J Surg 90:445–451PubMedCrossRef
18.
Zurück zum Zitat Schwandner O, Schiedeck TH, Bruch HP (1999) Advanced age—indication or contraindication for laparoscopic colorectal surgery? Dis Colon Rectum 42:356–362PubMedCrossRef Schwandner O, Schiedeck TH, Bruch HP (1999) Advanced age—indication or contraindication for laparoscopic colorectal surgery? Dis Colon Rectum 42:356–362PubMedCrossRef
19.
Zurück zum Zitat TCOoSTS Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef TCOoSTS Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
20.
Zurück zum Zitat Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P, Dellabona P, Di Carlo V (2002) Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg 236:759–766; disscussion 767 Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P, Dellabona P, Di Carlo V (2002) Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg 236:759–766; disscussion 767
21.
Zurück zum Zitat Fleshman JW, Wexner SD, Anvari M, LaTulippe JF, Birnbaum EH, Kodner IJ, Read TE, Nogueras JJ, Weiss EG (1999) Laparoscopic vs. open abdominoperineal resection for cancer. Dis Colon Rectum 42:930–939PubMedCrossRef Fleshman JW, Wexner SD, Anvari M, LaTulippe JF, Birnbaum EH, Kodner IJ, Read TE, Nogueras JJ, Weiss EG (1999) Laparoscopic vs. open abdominoperineal resection for cancer. Dis Colon Rectum 42:930–939PubMedCrossRef
22.
Zurück zum Zitat Lezoche E, Guerrieri M, De Sanctis A, Campagnacci R, Baldarelli M, Lezoche G, Paganini AM (2006) Long-term results of laparoscopic versus open colorectal resections for cancer in 235 patients with a minimum follow-up of 5 years. Surg Endosc 20:546–553PubMedCrossRef Lezoche E, Guerrieri M, De Sanctis A, Campagnacci R, Baldarelli M, Lezoche G, Paganini AM (2006) Long-term results of laparoscopic versus open colorectal resections for cancer in 235 patients with a minimum follow-up of 5 years. Surg Endosc 20:546–553PubMedCrossRef
23.
Zurück zum Zitat Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731–1740PubMedCrossRef Sauer R, Becker H, Hohenberger W, Rodel C, Wittekind C, Fietkau R, Martus P, Tschmelitsch J, Hager E, Hess CF, Karstens JH, Liersch T, Schmidberger H, Raab R (2004) Preoperative versus postoperative chemoradiotherapy for rectal cancer. N Engl J Med 351:1731–1740PubMedCrossRef
24.
Zurück zum Zitat Wittekind C, Meyer HJ, Bootz F (2003) UICC: TNM classification of malignant tumors, 6th edn. Springer, Berlin Wittekind C, Meyer HJ, Bootz F (2003) UICC: TNM classification of malignant tumors, 6th edn. Springer, Berlin
25.
Zurück zum Zitat Becker HD, Hohenberger W, Junginger T, Schlag PM (2002) Chirurgische Onkologie. Thieme, Stuttgart, New York Becker HD, Hohenberger W, Junginger T, Schlag PM (2002) Chirurgische Onkologie. Thieme, Stuttgart, New York
26.
Zurück zum Zitat Bruch HP, Herold A, Schiedeck TH, Schwandner O (1997) Laparoscopic surgery of rectal carcinoma. Zentralbl Chir 122:1134–1141PubMed Bruch HP, Herold A, Schiedeck TH, Schwandner O (1997) Laparoscopic surgery of rectal carcinoma. Zentralbl Chir 122:1134–1141PubMed
27.
Zurück zum Zitat Bruch HP, Schwandner O, Keller R (2003) Limitations of laparoscopic visceral surgery in oncology. Chirurg 74:290–300PubMedCrossRef Bruch HP, Schwandner O, Keller R (2003) Limitations of laparoscopic visceral surgery in oncology. Chirurg 74:290–300PubMedCrossRef
28.
Zurück zum Zitat Schlachta CM, Mamazza J, Seshadri PA, Cadeddu M, Gregoire R, Poulin EC (2001) Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44:217–222PubMedCrossRef Schlachta CM, Mamazza J, Seshadri PA, Cadeddu M, Gregoire R, Poulin EC (2001) Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44:217–222PubMedCrossRef
29.
Zurück zum Zitat Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332PubMedCrossRef Stocchi L, Nelson H, Young-Fadok TM, Larson DR, Ilstrup DM (2000) Safety and advantages of laparoscopic vs. open colectomy in the elderly: matched-control study. Dis Colon Rectum 43:326–332PubMedCrossRef
30.
Zurück zum Zitat Patankar SK, Larach SW, Ferrara A, Williamson PR, Gallagher JT, DeJesus S, Narayanan S (2003) Prospective comparison of laparoscopic vs. open resections for colorectal adenocarcinoma over a ten-year period. Dis Colon Rectum 46:601–611PubMedCrossRef Patankar SK, Larach SW, Ferrara A, Williamson PR, Gallagher JT, DeJesus S, Narayanan S (2003) Prospective comparison of laparoscopic vs. open resections for colorectal adenocarcinoma over a ten-year period. Dis Colon Rectum 46:601–611PubMedCrossRef
31.
Zurück zum Zitat Larach SW, Patankar SK, Ferrara A, Williamson PR, Perozo SE, Lord AS (1997) Complications of laparoscopic colorectal surgery. Analysis and comparison of early vs. latter experience. Dis Colon Rectum 40:592–596PubMedCrossRef Larach SW, Patankar SK, Ferrara A, Williamson PR, Perozo SE, Lord AS (1997) Complications of laparoscopic colorectal surgery. Analysis and comparison of early vs. latter experience. Dis Colon Rectum 40:592–596PubMedCrossRef
32.
Zurück zum Zitat Marusch F, Gastinger I, Schneider C, Scheidbach H, Konradt J, Bruch HP, Kohler L, Barlehner E, Kockerling F (2001) Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results. Surg Endosc 15:116–120PubMedCrossRef Marusch F, Gastinger I, Schneider C, Scheidbach H, Konradt J, Bruch HP, Kohler L, Barlehner E, Kockerling F (2001) Experience as a factor influencing the indications for laparoscopic colorectal surgery and the results. Surg Endosc 15:116–120PubMedCrossRef
33.
Zurück zum Zitat Duepree HJ, Senagore AJ, Delaney CP, Fazio VW (2003) Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg 197:177–181PubMedCrossRef Duepree HJ, Senagore AJ, Delaney CP, Fazio VW (2003) Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg 197:177–181PubMedCrossRef
34.
Zurück zum Zitat Lumley J, Stitz R, Stevenson A, Fielding G, Luck A (2002) Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes. Dis Colon Rectum 45:867–872. discussion 872–865 Lumley J, Stitz R, Stevenson A, Fielding G, Luck A (2002) Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes. Dis Colon Rectum 45:867–872. discussion 872–865
35.
Zurück zum Zitat Aziz O, Constantinides V, Tekkis PP, Athanasiou T, Purkayastha S, Paraskeva P, Darzi AW, Heriot AG (2006) Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol 13:413–424PubMedCrossRef Aziz O, Constantinides V, Tekkis PP, Athanasiou T, Purkayastha S, Paraskeva P, Darzi AW, Heriot AG (2006) Laparoscopic versus open surgery for rectal cancer: a meta-analysis. Ann Surg Oncol 13:413–424PubMedCrossRef
36.
Zurück zum Zitat Scheidbach H, Schneider C, Konradt J, Barlehner E, Kohler L, Wittekind C, Kockerling F (2002) Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum. Surg Endosc 16:7–13PubMedCrossRef Scheidbach H, Schneider C, Konradt J, Barlehner E, Kohler L, Wittekind C, Kockerling F (2002) Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum. Surg Endosc 16:7–13PubMedCrossRef
37.
Zurück zum Zitat Dulucq JL, Wintringer P, Stabilini C, Mahajna A (2005) Laparoscopic rectal resection with anal sphincter preservation for rectal cancer: long-term outcome. Surg Endosc 19:1468–1474PubMedCrossRef Dulucq JL, Wintringer P, Stabilini C, Mahajna A (2005) Laparoscopic rectal resection with anal sphincter preservation for rectal cancer: long-term outcome. Surg Endosc 19:1468–1474PubMedCrossRef
38.
Zurück zum Zitat Poulin EC, Schlachta CM, Gregoire R, Seshadri P, Cadeddu MO, Mamazza J (2002) Local recurrence and survival after laparoscopic mesorectal resection forrectal adenocarcinoma. Surg Endosc 16:989–995PubMedCrossRef Poulin EC, Schlachta CM, Gregoire R, Seshadri P, Cadeddu MO, Mamazza J (2002) Local recurrence and survival after laparoscopic mesorectal resection forrectal adenocarcinoma. Surg Endosc 16:989–995PubMedCrossRef
39.
Zurück zum Zitat Leung KL, Kwok SP, Lau WY, Meng WC, Chung CC, Lai PB, Kwong KH (2000) Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma. Surg Endosc 14:67–70PubMedCrossRef Leung KL, Kwok SP, Lau WY, Meng WC, Chung CC, Lai PB, Kwong KH (2000) Laparoscopic-assisted abdominoperineal resection for low rectal adenocarcinoma. Surg Endosc 14:67–70PubMedCrossRef
40.
Zurück zum Zitat Ptok H, Steinert R, Meyer F, Kroll KP, Scheele C, Kockerling F, Gastinger I, Lippert H (2006) Long-term oncological results after laparoscopic, converted and primary open procedures for rectal carcinoma. Results of a multicenter observational study. Chirurg 77:709–717PubMedCrossRef Ptok H, Steinert R, Meyer F, Kroll KP, Scheele C, Kockerling F, Gastinger I, Lippert H (2006) Long-term oncological results after laparoscopic, converted and primary open procedures for rectal carcinoma. Results of a multicenter observational study. Chirurg 77:709–717PubMedCrossRef
41.
Zurück zum Zitat Baker RP, White EE, Titu L, Duthie GS, Lee PW, Monson JR (2002) Does laparoscopic abdominoperineal resection of the rectum compromise long-term survival? Dis Colon Rectum 45:1481–1485PubMedCrossRef Baker RP, White EE, Titu L, Duthie GS, Lee PW, Monson JR (2002) Does laparoscopic abdominoperineal resection of the rectum compromise long-term survival? Dis Colon Rectum 45:1481–1485PubMedCrossRef
42.
Zurück zum Zitat Hong D, Tabet J, Anvari M (2001) Laparoscopic vs. open resection for colorectal adenocarcinoma. Dis Colon Rectum 44:10–18; discussion 18–19 Hong D, Tabet J, Anvari M (2001) Laparoscopic vs. open resection for colorectal adenocarcinoma. Dis Colon Rectum 44:10–18; discussion 18–19
43.
Zurück zum Zitat Law WL, Lee YM, Choi HK, Seto CL, Ho JW (2006) Laparoscopic and open anterior resection for upper and mid rectal cancer: an evaluation of outcomes. Dis Colon Rectum 49:1108–1115PubMedCrossRef Law WL, Lee YM, Choi HK, Seto CL, Ho JW (2006) Laparoscopic and open anterior resection for upper and mid rectal cancer: an evaluation of outcomes. Dis Colon Rectum 49:1108–1115PubMedCrossRef
44.
Zurück zum Zitat Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068PubMedCrossRef Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol 25:3061–3068PubMedCrossRef
Metadaten
Titel
Laparoscopic surgery for rectal cancer: oncological results and clinical outcome of 225 patients
verfasst von
Ayman Agha
Alois Fürst
Johanna Hierl
Igors Iesalnieks
Gabriel Glockzin
Matthias Anthuber
Karl-Walter Jauch
Hans J. Schlitt
Publikationsdatum
01.10.2008
Verlag
Springer-Verlag
Erschienen in
Surgical Endoscopy / Ausgabe 10/2008
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-008-0028-4

Weitere Artikel der Ausgabe 10/2008

Surgical Endoscopy 10/2008 Zur Ausgabe

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

TAVI versus Klappenchirurgie: Neue Vergleichsstudie sorgt für Erstaunen

21.05.2024 TAVI Nachrichten

Bei schwerer Aortenstenose und obstruktiver KHK empfehlen die Leitlinien derzeit eine chirurgische Kombi-Behandlung aus Klappenersatz plus Bypass-OP. Diese Empfehlung wird allerdings jetzt durch eine aktuelle Studie infrage gestellt – mit überraschender Deutlichkeit.

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.