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. 2017 Nov 27;9(11):215-223.
doi: 10.4240/wjgs.v9.i11.215.

Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre

Kristian Eeg Storli  1 , Kristin Bentung Lygre  1 , Knut Børge Iversen  2 , Maria Decap  2 , Geir Egil Eide  3
Affiliations

Laparoscopic complete mesocolic excisions for colonic cancer in the last decade: Five-year survival in a single centre

Kristian Eeg Storli et al. World J Gastrointest Surg. .

Abstract

Aim: To analyse clinical and long-term oncologic results after laparoscopic complete mesocolic excision (CME) for colonic cancer over a 10-year period.

Methods: Consecutive patients who received laparoscopic CME at our hospital from 2007 to 2017 were prospectively registered and retrospectively analysed. In total, 341 patients were included with tumour-nodal-metastasis (TNM) stages 0-III.

Results: The mean age of the patients was 71.9 years. The median length of stay was 5 d. The mean lymph node harvest was 17.8. The mortality rate was 1.2%. Fifteen patients were reoperated on for anastomotic leaks. The local recurrence rate was 2.3%. Five-year TTR and cancer-specific survival CSS were 83.1% and 90.3%. The location of the tumour was not a significant variable for survival in unadjusted and adjusted survival analysis. TNM stage and anastomotic leaks were significant variables with respect to survival.

Conclusion: Laparoscopic CME results in acceptable complication rates and long-term oncologic results. It is important to avoid anastomotic leaks because of their negative effect on survival.

Keywords: Cancer specific survival; Central vascular ligature; Colonic cancer; Complete mesocolic excision; Laparoscopic surgery; Time to recurrence.

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Conflict of interest statement

Conflict-of-interest statement: The authors of this manuscript have no conflict- of- interest to disclose.

Figures

Figure 1
Figure 1
Time to recurrence shown according to resection type for 341 patients with colonic cancer operated on with laparoscopic complete mesocolic excision in a Norwegian community teaching hospital during 2007-2017 (P = NS).
Figure 2
Figure 2
Cancer-specific survival shown according to resection type for 341 patients with colonic cancer operated on with laparoscopic complete mesocolic excision in a Norwegian community teaching hospital during 2007-2017 (P = NS).
Figure 3
Figure 3
Time to recurrence shown according to reoperation for anastomotic leak for 341 patients with colonic cancer operated on with laparoscopic complete mesocolic excision in a Norwegian community teaching hospital during 2007-2017 (P = 0.037).
Figure 4
Figure 4
Time to recurrence and anastomotic leakage. A: Survival curves for time to recurrence (TTR) from a Cox regression model for patients with right colonic cancer operated on with laparoscopic complete mesocolic excision (CME) in a Norwegian community teaching hospital during 2007-2015 with or without an anastomotic leak (P = 0.037); B: TTR shown as Cox regression curves for patients with right flexure or right proximal transverse colonic cancer operated on with laparoscopic CME in a Norwegian community teaching hospital during 2007-2015 with or without an anastomotic leak (P = 0.037); C: TTR shown as Cox regression curves for patients with left transverse, left flexure or descending colon cancer operated on with laparoscopic CME in a Norwegian community teaching hospital during 2007-2015 with or without an anastomotic leak (P = 0.037); D: TTR shown as Cox regression curves for patients with sigmoid or recto-sigmoid colon cancer operated on with laparoscopic CME in a Norwegian community teaching hospital during 2007-2015 with or without an anastomotic leak (P = 0.037).
Figure 5
Figure 5
Cancer-specific survival shown according to reoperation for anastomotic leak for 341 patients with colonic cancer operated on with laparoscopic complete mesocolic excision in a Norwegian community teaching hospital during 2007-2017 (P = 0.023).
See this image and copyright information in PMC

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