Laparoscopic Total Mesorectal Excision for Extraperitoneal Rectal Cancer: Long-Term Results of a 18-Year Single-Centre Experience
Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract(2014)
摘要
Background and Objectives The oncologic efficacy of laparoscopic total mesorectal excision (TME) for middle–low rectal cancer is still under discussion because of the few long-term data. This study reports the results arising from a single-institution experience during a 18-year period. Methods Data about 132 consecutive laparoscopic TME performed between January 1994 and January 2012 were analysed with Kaplan–Meier method and a uni- and multi-variate analysis was conducted to define independent survival predictors. Results A total of 116 sphincter-preserving operations and 16 abdominoperineal resections were performed. Postoperative mortality and morbidity were 0.8 and 18.2 %, with a rate of anastomotic leakage of 13.8 %. Average follow-up was 85.9 months (range 13–210). Actuarial local recurrence rate was 4.13 % at 5 years (any pelvic recurrence developed after 3 years from surgery). Overall and disease-free survival was respectively 83 and 79.8 % at 5 years, 71 and 73 % at 10 years and then remained constant until 18 years. Survival was correlated only to tumour stage and the type of surgery. Conclusions Laparoscopic TME for extraperitoneal rectal cancer shows long-term oncologic outcomes similar to open rectal resections.
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关键词
Total mesorectal excision,Rectal cancer,Laparoscopy,Long-term follow-up
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