Laparoscopic colorectal surgery for cancer: intermediate to long-term outcomes.
OBJECTIVE
Since 1991, a laparoscopic-assisted resection has been used at the Royal Brisbane Hospital selectively for patients with colorectal cancer. This article audits the intermediate to long-term postoperative complications and cancer follow-up data.


METHODS
All patients undergoing a laparoscopic resection for cancer were prospectively followed up with regard to long-term outcomes.


RESULTS
One hundred eighty-one patients have been studied. One hundred fifty-four patients had potentially curative procedures performed in the study period. Median follow up was 71 (range, 7-108) months. The overall recurrence rate in this group was 6 percent (21 recurrences). There was one port site recurrence after a potentially curative procedure (0.6 percent) and one port site recurrence after a palliative resection. Perioperative mortality was 1 percent (2 patients). Only six patients suffered an adhesive small-bowel obstruction postoperatively. There was one incisional hernia. Unadjusted five-year median survival data for Australian Clinico-pathological Staging A was 91 percent (3.5 percent recurrence); for Australian Clinico-pathological Staging B, 83 percent (15 percent recurrence); and for Australian Clinico-pathological Staging C, 74 percent (26 percent recurrence).


CONCLUSIONS
In selected patients a laparoscopic resection for colorectal cancer produces acceptable intermediate to long-term oncologic outcomes and a low long-term complication rate.
Royal Brisbane Hospital, Herston, Queensland, Australia.
John
J
Lumley
Russell
R
Stitz
Andrew
A
Stevenson
George
G
Fielding
Andrew
A
Luck
D003082:Colectomy / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008485:Medical Audit; D009364:Neoplasm Recurrence, Local; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011446:Prospective Studies; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome