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Ten-year outcomes following laparoscopic colorectal resection: results of a randomized controlled trial

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the impact of laparoscopy compared to open surgery on long-term outcomes in a large series of patients who participated in a randomized controlled trial comparing short-term results of laparoscopic (LPS) versus open colorectal resection.

Methods

This is a retrospective review of a prospective database including 662 patients with colorectal disease (526, 79 % cancer patients) who were randomly assigned to LPS or open colorectal resection and followed every 6 months by office visits. The primary endpoint of the study was long-term morbidity. Secondary outcomes included 10-year overall, cancer-specific, and disease-free survivals. All patients were analyzed on an intention-to-treat basis.

Results

Fifty-eight (8.8 %) patients were lost to follow-up. Median follow-up was 131 (IQR 78–153) months in the LPS group and 126 (IQR 52–152) months in the open group (p = 0.121). Overall, long-term morbidity rate was 11.8 % (36/309) in the LPS versus 12.6 % (37/295) in the open group (p = 0.770). Incisional hernia rate was 5.8 % (18/309) in the LPS group versus 8.1 % (24/295) in the open group (p = 0.264). Adhesion-related small-bowel obstruction occurred in five (1.6 %) patients in the LPS versus four (1.4 %) patients in the open group (p = 1.000). In 497 cancer patients, 10-year overall survival was 45.3 % in the LPS group and 40.9 % in the open group (p = 0.160). No difference was found in cancer-specific and disease-free survivals, also when patients were stratified according to cancer stage.

Conclusion

In this series, LPS colorectal resection was not associated with a lower long-term morbidity rate when compared to open surgery. Overall, cancer-specific and disease-free survivals were similar in cancer patients who were treated with LPS and open surgeries.

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Authors and Affiliations

  1. Department of Surgery, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Nicolò Pecorelli, Salvatore Amodeo, Matteo Frasson, Andrea Vignali, Walter Zuliani & Marco Braga

Authors
  1. Nicolò Pecorelli
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  2. Salvatore Amodeo
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  3. Matteo Frasson
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  4. Andrea Vignali
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  5. Walter Zuliani
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  6. Marco Braga
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Corresponding author

Correspondence to Marco Braga.

Ethics declarations

The local Ethical Committee approved the study protocol, and patients signed a written informed consent before randomization.

Conflict of interest

The authors declare that they have no conflict of interest.

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Pecorelli, N., Amodeo, S., Frasson, M. et al. Ten-year outcomes following laparoscopic colorectal resection: results of a randomized controlled trial. Int J Colorectal Dis 31, 1283–1290 (2016). https://doi.org/10.1007/s00384-016-2587-5

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  • DOI: https://doi.org/10.1007/s00384-016-2587-5

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