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Survival following oncological minimally invasive colorectal procedures

Überleben nach onkologischen minimal invasiven kolorektalen Eingriffen

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Summary

Background: Since 1992, oncological minimally invasive colorectal procedures are routinely performed at our institution. The aim of this study was to evaluate postoperative survival.

Methods: A retrospective analysis assessing postoperative survival following oncological minimally invasive colorectal procedures conducted from March 1992 to September 1998 is presented. Mean postoperative follow-up for all patients was 5.5 years.

Results: Minimally invasive colorectal procedures were conducted in 105 patients for treatment of carcinoma of caecum (n=8); ascending (n=21), transverse (n=4), descending (n=7) and sigmoid colon carcinoma (n=30); and rectal carcinoma (n=35). The procedures conducted were ileocaecal resection (n=3), right hemicolectomy (n=26), resection of transverse colon (n=4), left hemicolectomy (n=4), resection of descending colon (n=3), sigmoid resection (n=30), rectal resection (n=26), amputation of the rectum (n=8), and sigmoidostomy (n=1). Postoperative mortality was 1.0% (n=1). Following 90 curative colorectal resections, local recurrence developed in five patients (5.6%) and two trocar-site metastases were observed (2.2%). Mean 5-year survival for stages I–III was 68% for curative colorectal resections (87%, 91% and 28% for stages I, II and III, respectively,n=83; 44% vs. 20% for IIIA vs. IIIB,n=29). Seven patients (8%) died from tumour-unrelated causes. Mean survival following palliative resections was 10.5 months (n=15).

Conclusions: Up to now, in our experience, postoperative survival following minimally invasive colorectal resections is comparable to that following ‘open’ surgery. Additional trials are required in order to compare long-term outcomes.

Zusammenfassung

Grundlagen: An unserer Abteilung werden seit 1992 onkologische minimal invasive kolorektale Operationen durchgeführt. Mit dieser Studie wurde das postoperative Überleben untersucht.

Methodik: Wir führten eine retrospektive Analyse des Überlebens aller an unserer Abteilung von März 1992 bis September 1998 wegen kolorektaler Malignome minimal invasiv operierten Patienten durch. Die mittlere Nachbeobachtungszeit betrug 5,5 Jahre.

Ergebnisse: Bei 105 Patienten wurden wegen Karzinomen im Coecum (n=8), Kolon ascendens (n=21), transversum (n=4), descendens (n=7) und sigmoideum (n=30) sowie am Rektum (n=35) folgende minimal invasive kolorektale Eingriffe durchgeführt: Ileocoecalresektion (n=3), Hemikolektomie rechts (n=26), Transversumresektion (n=4), Hemikolektomie links (n=4), Descendensresektion (n=3), Sigmaresektion (n=30), Rektumresektion (n=26), Rektumamputation (n=8), Sigmoideostomie (n=1). Die postoperative Mortalität betrug 1,0% (n=1). Nach 90 kurativen kolorektalen Resektionen beobachteten wir 5 Lokalrezidive (5,6%) und in 2 Fällen Trokarmetastasen (2,2%). Das 5 Jahres Überleben der Tumor-Stadien I–III beträgt 68% (87%, 91% bzw. 28% für Stadium I, II und III,n=83; 44% vs. 20% für IIIA vs. IIIB,n=29). Sieben Patienten (8%) sind an nicht Tumor-assoziierten Erkrankungen verstorben. Die mittlere Überlebenszeit nach palliativen kolorektalen Eingriffen beträgt 10,5 Monate (n=15).

Schlußfolgerungen: Nach onkologischen minimal invasiven kolorektalen Eingriffen kann in unserem Krankengut ein mit der „offenen“ Chirurgie vergleichbares Überleben beobachtet werden. Weitere Studien sind notwendig, um die Langzeitergebnisse zu vergleichen.

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Authors and Affiliations

  1. Division of Surgery, Hospital Bregenz, Carl-Pedenz-Straße 2, A-6900, Bregenz

    M. Riegler, W. Müller, S. Beller & G. Szinicz M.D.

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  1. M. Riegler
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  2. W. Müller
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  4. G. Szinicz M.D.
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Correspondence to G. Szinicz M.D..

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Riegler, M., Müller, W., Beller, S. et al. Survival following oncological minimally invasive colorectal procedures. Eur. Surg. 34, 354–358 (2002). https://doi.org/10.1046/j.1563-2563.2002.02075.x

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