Lokalrecidiv efter operation for cancer recti. Resultatet af en aendret kirurgisk metode udfört af få specialiserede kirurger
Engelsk titel: Local recurrence after rectal cancer resection. The result of an improved procedure performed by a few specialised surgeons
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Författare:
Bulow S
;
Kumler T
;
Christensen IJ
Email: sbulow@dadlnet.dk
Språk: Dan
Antal referenser: 19
Dokumenttyp:
Artikel
UI-nummer: 05051694
Sammanfattning
Introduction: In 1986-1990, the local recurrence rate was 39% after conventional rectal cancer resection in patients operated upon at Hvidovre Hospital. We now present the results after total mesorectal excision, performed by a few experienced surgeons. Materials and methods: Seventy-nine of 164 patients with rectal cancer diagnosed and treated at Hvidovre Hospital had a mesorectal excision with curative intent. The operation was performed or supervised by one of three rectal surgeons, and the patients were followed for five years. Data registration included demography, tumour stage, perioperative course, local recurrence, metastasis and survival rate. Results: Six patients (8%) had a local recurrence, and the cumulative five-year local recurrence rate was 11% (95%, c.l. 2-19). Sixteen developed distant metastases. After five years, the cumulative crude survival rate was 53% (95% c.l. 42-64), and the cumulative relative survival rate was 73% (95% c.l. 62-84). Discussion: This and other Nordic studies indicate that total mesorectal excision performed by a few trained surgeons results in a substantial reduction of the risk of local cancer recurrence and an improved survival rate. In the future, rectal cancer surgery should be centralised to fewer hospital departments and include specialised rectal surgeons as part of a multidisciplinary colorectal cancer team.