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Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer

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Diseases of the Colon & Rectum

Abstract

PURPOSE: Laparoscopic colorectal surgery for cancer is currently under discussion. Results of large, randomized studies will not be available for a number of years yet. This study analyses the results of such resections in consecutive patients operated on by unselected surgeons. METHODS: A prospective, observational, multicenter study was initiated on August 1, 1995, in the German-speaking countries of Europe. One year after initiation of the study, findings are presented with respect to the quality of oncologic resections. RESULTS: Of 500 operations, 231 (46 percent) were performed for cancer, 167 (33 percent) with a curative intent. The most common curative resections were as follows: 63 anterior rectum resections (38 percent), 51 sigmoid resections (30 percent), and 27 abdominoperineal resections (16 percent). Segmental resections were performed in 20 patients (12 percent). Intraoperative tumor spillage was reported in 2 percent. Mean number of lymph nodes harvested was 13 (confidence interval, 5–95 percent; range, 11.5–14.6) and positive lymph nodes harvested was 2.2 (confidence interval, 5–95 percent; range, 0.9–3.4). Significant differences were noted between participating centers in terms of number of lymph nodes resected (P<0.0001). Distal and proximal resection margins were tumorfree in every case. Lateral margins were tumor-free when examined. In the case of 63 curative anterior resections, the mean distal resection margin was 39 (confidence interval, 5–95 percent; range, 33–45) mm, and in 8 of these resections, it was less than 20 mm. Mean blood loss was 344 (confidence interval, 5–95 percent; 292–396) ml, and 21 percent of patients received blood transfusions. CONCLUSIONS: These data document that the average quality of laparoscopic colorectal procedures for cancer is satisfactory but differs among surgeons.

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Authors and Affiliations

  1. Department of Surgery, University of Erlangen, P.O. Box 3560, D-91023, Erlangen, Germany

    Ferdinand Köckerling M.D., Marc A. Reymond M.D., Claus Schneider M.D., Christian Wittekind M.D., Hubert Scheidbach M.D., Jochen Konradt M.D., Lothar Köhler M.D., Eckhard Bärlehner M.D., Andreas Kuthe M.D., Hans-Peter Bruch M.D. & Werner Hohenberger M.D.

Authors
  1. Ferdinand Köckerling M.D.
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  2. Marc A. Reymond M.D.
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  3. Claus Schneider M.D.
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  4. Christian Wittekind M.D.
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  5. Hubert Scheidbach M.D.
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  6. Jochen Konradt M.D.
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  7. Lothar Köhler M.D.
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  8. Eckhard Bärlehner M.D.
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  9. Andreas Kuthe M.D.
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  10. Hans-Peter Bruch M.D.
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  11. Werner Hohenberger M.D.
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The Laparoscopic Colorectal Surgery Study Group

Additional information

The ongoing multicenter study is supported in part by a grant from Ethicon Endosurgery, Norderstedt, Germany, and Takeda Pharma, Aachen, Germany.

Read at the Annual Congress of the Society of the American Gastrointestinal Endoscopic Surgeons, San Diego, California, March 21 to 23, 1997.

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Köckerling, F., Reymond, M.A., Schneider, C. et al. Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. Dis Colon Rectum 41, 963–970 (1998). https://doi.org/10.1007/BF02237381

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