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Long-term oncologic outcome after laparoscopic surgery for rectal cancer

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Abstract

Background

Recent studies demonstrated favorable short- and mid-term results after laparoscopic surgery for rectal cancer. However, long-term results from large series are lacking. The present study analyses long-term results of laparoscopic rectal cancer surgery from a large-volume center.

Methods

From January 1998 until March 2005, 225 patients underwent laparoscopic rectal resection due to carcinoma at the Medical Centre of the University of Regensburg. From 224 patients, a follow-up over 10 years was performed using the data of the Tumour Centre of the University of Regensburg. The data were analysed using oncological data (tumour recurrence) as well as overall survival. In addition, the effect of conversion to open resection on overall survival was analysed.

Results

With a median of 10 years at follow-up, the overall and disease-free survival was 50.5 and 50.1 %, respectively. Local recurrence of all patients was 5.8 % and none of the converted patients was within this group. The median time interval for the development of local recurrence was 30 months. Six of the 13 patients with local recurrence (46.1 %) had received neoadjuvant radiochemotherapy before surgery. Patients with a conversion to open surgery had primarily a significantly worse outcome than patients resected completely laparoscopically (p = 0.003). However, this difference was no longer apparent using a multivariant analysis (hazard ratio 1.221; p = 0.478).

Conclusions

Overall survival and local recurrence rate of patients undergoing laparoscopic resection of rectal cancer are comparable to open surgery. However, in our analysis, patients undergoing laparoscopic anterior resection had a higher survival rate compared with patients with abdominoperineal resection.

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Abbreviations

AR:

Anterior resection

APR:

Abdominoperineal resection

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Acknowledgments

The authors thank Richard John Heald for critical reading of the manuscript.

Disclosures

Drs. Agha, Benseler, Hornung, Gerken, Iesalnieks, Fürst, Anthuber, Jauch and Schlitt have no conflict of interest or financial ties to disclose.

Author information

Author notes

  1. Igors Iesalnieks

    Present address: Department of Surgery, Marienhospital Gelsenkirchen, Gelsenkirchen, Germany

  2. Alois Fürst

    Present address: Department of Surgery, Caritas-Krankenhaus St. Josef, Regensburg, Regensburg, Germany

  3. Matthias Anthuber

    Present address: Department of Surgery, Klinikum Augsburg, Augsburg, Germany

  4. Karl-Walter Jauch

    Present address: Department of Surgery, University of Munich Campus Grosshadern, Munich, Germany

Authors and Affiliations

  1. Department of Surgery, University Medical Centre Regensburg, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Germany

    Ayman Agha, Volker Benseler, Matthias Hornung, Igors Iesalnieks, Alois Fürst, Matthias Anthuber, Karl-Walter Jauch & Hans J. Schlitt

  2. Tumour Center Regensburg, Regensburg, Germany

    Michael Gerken

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  1. Ayman Agha
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Correspondence to Volker Benseler.

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Agha, A., Benseler, V., Hornung, M. et al. Long-term oncologic outcome after laparoscopic surgery for rectal cancer. Surg Endosc 28, 1119–1125 (2014). https://doi.org/10.1007/s00464-013-3286-8

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  • DOI: https://doi.org/10.1007/s00464-013-3286-8

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