Laparoscopic colorectomy for colorectal cancer: retrospective analysis of 889 patients in a single center.
Laparoscopic colectomy has been reported as an alternative for treatment of colorectal cancer.  However, its long-term efficacy and safety remain obscure.  The purpose here was to review our experience with laparoscopic colectomy in 899 patients between June 2001 and December 2008.  Of them, 43 patients were converted to open surgery and 846 accepted laparoscopic colorectomy successfully.  Among these 846 patients, 790 patients underwent radical resection and 56 patients underwent palliative resection.  Only 1 patient died from perioperative pulmonary infection; thus the mortality was 0.12% (1/846).  The morbidity of perioperative complications was 18.20% (154/846): intraoperative complication rate was 4.49% (38/846) and the most common intraoperative complication was subcutaneous emphysema and hypercapnia (1.65%, 14/846); postoperative complication rate was 13.71% (116/846) and the most common postoperative complication was ileus (4.37%, 37/846).  The overall followed-up rate was 86.41% (731/846, 680 for radical operations and 51 palliative operations).  Postoperative deaths happened to 139 patients, including 112 after radical operation and 27 after palliative resection.  Of these 112 patients, 97 deaths were cancer-related (14.26%, 97/680) and 15 deaths were non-cancer-related.  There were 10 patients encountered local recurrence (1.47%, 10/680) and 105 for metastasis (15.44%, 105/680) after radical operation.  Forty-two patients are still alive with tumor.  Overall survival rate was 80.98% (592/731), 3-year disease-free survival (DFS) rate after radical operation was 78.0%, and 3-year DFS rate after radical operation for stage I, stage II, and stage III was 89.0%, 85.0%, and 65.0%, respectively.  In conclusion, laparoscopic colorectal resection is a feasible and safe technology for colorectal cancer.
Department of Gastroenterology, The Tenth People's Hospital of Tongji University, Shanghai, P.R. China.
Liesheng
L
Lu
Donglei
D
Zhou
Xun
X
Jian
Jianzhong
J
Deng
Ping
P
Yang
Weixing
W
Ding
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D003107:Colorectal Surgery / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications / Q000209:etiology; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013525:Surgical Instruments; D016896:Treatment Outcome; D055815:Young Adult