Digestive Surgery
Original Paper
Outcome after Introduction of Complete Mesocolic Excision for Colon Cancer Is Similar for Open and Laparoscopic Surgical TreatmentsStorli K.E.a · Søndenaa K.a, b · Furnes B.a · Eide G.E.c, daDepartment of Surgery, Haraldsplass Deaconess Hospital, Departments of bClinical Medicine and dGlobal Public Health and Primary Care, University of Bergen, and cCentre for Clinical Research, Haukeland University Hospital, Bergen, Norway
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Dig Surg 2013;30:317-327
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Article / Publication Details
First-Page Preview
Received: May 22, 2013
Accepted: July 23, 2013
Published online: September 10, 2013
Issue release date: March 2014
Number of Print Pages: 11
Number of Figures: 6
Number of Tables: 5
ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)
For additional information: https://www.karger.com/DSU
Abstract
Background: Complete mesocolic excision (CME) and a high (apical) vascular tie may improve oncologic outcome after surgery for colon cancer. Our primary aim was to emulate a previous national result of 73.8% overall survival (OS) with both the open and laparoscopic techniques. Methods: A prospective study of radical colon cancer was initiated in a Norwegian community teaching hospital in 2007 and comprised a consecutive group of 251 patients with TNM stages I-III that had surgery according to the CME principle. Oncological outcome was assessed as OS, disease-free survival (DFS) and cancer-specific survival (CSS), as well as time to recurrence (TTR), using Cox regression analysis. Results: In-hospital mortality was 3.6%, 2.3% for laparoscopic surgery and 4.9% for open management. Significantly more patients in the open CME group developed complications in the short term (p < 0.001). Twelve or more lymph nodes were retrieved from 82.9% (208/251) of the specimens. Overall 3-year OS was 84.5%, DFS 77.4%, CSS 91.5% and TTR 86.8%. The surgical approach was not a significant predictor for any of the survival parameters. Conclusions: There was no survival difference between open and laparoscopic CME colonic resections, and the present OS improved from a previous OS from 2000.
© 2013 S. Karger AG, Basel
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Article / Publication Details
First-Page Preview
Received: May 22, 2013
Accepted: July 23, 2013
Published online: September 10, 2013
Issue release date: March 2014
Number of Print Pages: 11
Number of Figures: 6
Number of Tables: 5
ISSN: 0253-4886 (Print)
eISSN: 1421-9883 (Online)
For additional information: https://www.karger.com/DSU
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