Laparoskopisk assisteret colonkirurgi. En prospektiv opgörelse af tidlige resultater og 12-38 måneders followuptid
Engelsk titel: Laparoscopy-assisted colon resection. A prospective study with short-term results and 12-38 months' follow-up
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Författare:
Bulut O
;
Brink L
;
Jess P
Email: orbu@fa.dk
Språk: Dan
Antal referenser: 17
Dokumenttyp:
Artikel
UI-nummer: 05081287
Sammanfattning
Introduction: Despite several reports demonstrating its clinical benefits, laparoscopy-assisted colectomy (LAC) has not gained universal acceptance because of its oncologic implications. In this article we present our experiences with LAC. Materials and methods: A consecutive series of 75 patients undergoing LAC between February 2001 and March 2003 was followed. Fifty-nine of the patients had colon cancer. Standardized postoperative care procedures were used. The median follow-up time for the colon cancer patients was 19 months (range 12-38 months). Results: The median operation time was 190 minutes (range 150-300 minutes). Two patients (3%) required a conversion to laparotomy. Ten patients (13%) suffered from postoperative complications. The postoperative mortality rate was 3%. The median length of stay for the patients who were directly discharged to their home was 4 days (range 1-30 days). There were no readmissions in the postoperative period. Fifty-five patients with malignancy underwent curative resection, while four, who had metastatic disease, were operated on for palliation. The frequency of recurrence and the cancer-related mortality rate in the follow-up period were both 21%. No significant differences were found between patients with Dukes' type B and type C with regard to being free of recurrence or cancer-related survival. One port-site recurrence (2%) occured in the patients who underwent curative resection. Discussion: Our results shows that LAS has clinical advantages, especially in the short term, and provides better oncologic results than open surgery, especially in cases of Dukes' type C cancer. LAC for cancer should be performed by experienced hands and monitored adequately by a national register to ensure satisfactory oncologic outcomes.