Laparoscopic surgery for rectal cancer: oncological results and clinical outcome of 225 patients.
BACKGROUND
The efficacy and feasibility of laparoscopic resection for rectal cancer has been proved, but the results of prospective, randomized studies are not yet available. Here we present a prospective observational study evaluating oncological and clinical outcome after laparoscopic surgery in patients with rectal cancer.


METHODS
Between January 1998 and March 2005, 225 patients with rectal adenocarcinoma underwent laparoscopic surgery at the University of Regensburg Medical Center. Clinical and oncological outcome of these patients including perioperative and long-term complications was evaluated. Survival curves were calculated according to the Kaplan-Meier method. Minimum follow-up was 24 months.


RESULTS
The distribution of the International Union against Cancer (UICC) stages was: 37.7% stage I, 20.5% stage II, 24.9% stage III, and 16.9% stage IV. Local recurrence was diagnosed in 5.8% and distant metastases in 8.1% of cases after mean follow-up of 36.4 months. The 5-year overall survival rate was 75.7% after curative and 40.7% after palliative surgery (p<0.05). The stage-related survival rates were 86.7% for UICC stage I, 61.7% for stage II, 68.1% for stage III, and 40.1% for stage IV.


CONCLUSIONS
Our results demonstrate the efficacy and technical feasibility of laparoscopic surgery for rectal cancer regarding the perioperative morbidity and the oncological outcome.
Agha
Ayman
A
Department of Surgery, University of Regensburg Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany. ayman.agha@klinik.uni-regensburg.de
Fürst
Alois
A
Hierl
Johanna
J
Iesalnieks
Igors
I
Glockzin
Gabriel
G
Anthuber
Matthias
M
Jauch
Karl-Walter
KW
Schlitt
Hans J
HJ
D000230:Adenocarcinoma / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000601:surgery*; D016896:Treatment Outcome