The impact of laparoscopic surgery in colorectal cancer resection with respect to the development of liver metastasis in the long-term

Abstract

Introduction Colorectal cancer (CRC) shows high incidence and mortality worldwide, particularly in Western and developed countries. The objective of this study is to evaluate the oncologic results during a minimum follow-up of 2 years of curable CRC patients submitted to laparoscopic resection in our environment, regarding to the development of hepatic metastases. Methods Medical records of 189 colon and rectal patients with potentially curable adenocarcinoma who have been submitted to laparoscopic resection have been reviewed through a retrospective cohort between January 2005 and March 2012 at a single institution regarded as reference to this type of treatment. Pearson's χ 2 and Long-rank tests have been used for statistical analysis and data was analyzed by statistic package STATA version 11.0. Results The eligible population for the study was 146 patients, 91 women (62%), with a mean age of 61 ± 13 years. Minimum follow-up was 24 months, having an mean follow-up of 60 ± 27 months and an mean follow-up of global disease recurrence of 27 ± 11 months. Hepatic metastases occurred in 7.5% of the population, most from stage III, and the mean recurrence period was 25 ± 16 months. Conclusions Laparoscopic resection for potentially curable CRC in this cohort did not change the long-term incidence of hepatic metastases, considering that our results are comparable to large randomized clinical trial results. Laparoscopic resection was effective and safe for analyzed patients, regarding long-term oncologic results.

Outcome of Laparoscopic Resection for Left Sided Colon and Rectal Cancer

“…In our study, circumferential margin (CRM) was free in all cases of rectal cancer ex-cept one case (3.45%) showed involved or positive CRM which is similar to that concluded by Rostirolla et al, 2016 who found a rate of 5.66% of circumferential margins committed [7].…”

“…The radicality of resection and the oncological results were initially a matter of debate limiting the spread of laparoscopic colorectal surgery [5] [6]. A series of studies showed that, in experienced hands, laparoscopic colorectal surgery has a valuable effect on post-operative recovery, compared to open surgery, without compromising the oncological results [7].…”

Metástasis hepáticas en el cáncer colorrectal: estrategias terapéuticas y recomendaciones actuales

“…Con el avance de las técnicas mínimamente invasivas, ahora es posible realizar procedimientos mayores completamente laparoscópicos de manera segura, con resultados oncológicos equiparables a los de la cirugía abierta y con una aceptable morbimortalidad 39,40 , y, además, con menor tasa de sangrado, menor tasa de infección y una recuperación más rápida [41][42][43][44][45] . Para conseguir estos resultados, Vigano, et al, consideran necesaria una adecuada curva de entrenamiento y practicar, como mínimo, 60 procedimientos, lo cual solo es posible en centros de alta complejidad y con gran volumen de casos de este tipo 46 .…”