caa a22 4500 475779614 CHVBK 20180406123640.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s004640000169 doi (NATIONALLICENCE)springer-10.1007/s004640000169 Laparoscopic surgery for stage III colon cancer [Elektronische Daten] Long-term follow-up [M. E. Franklin, G. B. Kazantsev, D. Abrego, J. A. Diaz-E, J. Balli, J. L. Glass] Background: The role of laparoscopic surgery in the management of colorectal cancer is controversial. This study was undertaken to determine the oncological adequacy, in terms of margins of resection, lymph node harvest, and anastomotic and locoregional recurrence of laparoscopic colectomy in patients with stage III (node-positive) colorectal cancer. Methods: The results of laparoscopic colectomy in 50 consecutive patients with stage III colorectal cancer operated on at a single hospital between 1991 and 1998 were analyzed with respect to postoperative morbidity, mortality, and long-term survival by the Kaplan-Meier method. Methodical patient follow-up was the mainstay of the study. Results: There were 31 men (52%) and 19 women (38%) with a mean age of 67.7 years (range, 40-88). Low anterior resection was performed in 17 cases, abdominal perineal resection in five cases sigmoid colectomy in 10 cases, left hemicolectomy in six cases, right hemicolectomy in seven cases, transverse colectomy in one case, and subtotal colectomy in four cases. Conversion was necessary in three cases (6%). Major complications included one leak, one pelvic abscess, one perineal wound infection, and three anastomotic strictures early in the experience, with none in the past 4 years. One early death occurred due to massive stroke. Median length of stay was 6 days (range, 3-37). Forty-six patients were staged as CII and four as CI colon cancer. The average number of positive nodes was 5.1 (range, 3-58). The margins of resection were adequate in all patients. Follow-up ranged from 3 to 75 months (average, 29.3; median, 24). Overall cancer-related mortality was 34% (17 patients); three patients died of unrelated causes with no detectable cancer. All who died of cancer had distant disease; three of them also had pelvic recurrence. Mean time of death was 21.7 months. There were no anastomotic recurrences or trocar site implants. Overall 3- and 5-year survival was 54.5% and 38.5%, respectively; cancer-adjusted survival was 60.8% and 49.1%. Conclusions: Based on this study, laparoscopic colectomy in patients with stage III colorectal cancer is oncologically adequate. It results in a long-term outcome comparable to that of traditional open surgery and is associated with low perioperative mortality and morbidity (lower wound infection rate, lower wound recurrences at trocar sites) and a shortened length of stay. Springer-Verlag New York Inc., 2000 Key words: Laparoscopic colectomy — Colorectal cancer — Mortality — Long-term survival — Cancer nationallicence Franklin M. E. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut Kazantsev G. B. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut Abrego D. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut Diaz-E J. A. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut Balli J. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut Glass J. L. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 612-616 0930-2794 14:7<612 2000 14 464 https://doi.org/10.1007/s004640000169 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004640000169 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Franklin M. E. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut NATIONALLICENCE 700 1- Kazantsev G. B. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut NATIONALLICENCE 700 1- Abrego D. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut NATIONALLICENCE 700 1- Diaz-E J. A. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut NATIONALLICENCE 700 1- Balli J. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut NATIONALLICENCE 700 1- Glass J. L. Texas Endosurgery Institute, 4242 East Southcross Boulevard, Suite #1, San Antonio, TX 78222, USA, USA aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/7(2000-07-01), 612-616 0930-2794 14:7<612 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer