Clinical Trials Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2017; 9(11): 215-223
Published online Nov 27, 2017. 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, Kristin Bentung Lygre, Knut Børge Iversen, Maria Decap, Geir Egil Eide
Kristian Eeg Storli, Kristin Bentung Lygre, Department of Surgery, Haraldsplass Deaconess Hospital, Department of Clinical Medicine, University of Bergen, Bergen 5009, Norway
Knut Børge Iversen, Maria Decap, Department of Surgery, Haraldsplass Deaconess Hospital, Bergen 5009, Norway
Geir Egil Eide, Centre for Clinical Research, Haukeland University Hospital, Department of Global Public Health and Primary Care, University of Bergen, Bergen 5009, Norway
Author contributions: Storli KE designed the study, drafted the manuscript, collected the data and performed the statistical analysis; Lygre KB assisted in data collection and read and revised the manuscript; Iversen KB and Decap M operated several of the patients of the study and read the manuscript; Eide GE approved the statistical analysis and the manuscript text and content.
Institutional review board statement: This study is part of a prospective project at Haraldsplass Deaconess Hospital. The Regional Ethical Committee for Medical Research in Western Norway approved the study. Consequently, all necessary approvals were gained from other official bodies connected with medical and biological research approval in Norway.
Clinical trial registration statement: The clinical trial is registered with clinicaltrials.gov (NCT00963352).
Informed consent statement: All study participants, or their legal guardian, provided written consent prior to study enrolment.
Conflict-of-interest statement: The authors of this manuscript have no conflict- of- interest to disclose.
Data sharing statement: There is no additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kristian Eeg Storli, MD, PhD, Department of Surgery, Haraldsplass Deaconess Hospital, Department of Clinical Medicine, University of Bergen, POB 6165, Bergen 5009, Norway. kristian.eeg.storli@haraldsplass.no
Telephone: +47-92-698708 Fax: +47-55-978555
Received: May 28, 2017
Peer-review started: June 12, 2017
First decision: July 11, 2017
Revised: August 20, 2017
Accepted: September 14, 2017
Article in press: September 15, 2017
Published online: November 27, 2017
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: Complete mesocolic excision, Central vascular ligature, Colonic cancer, Laparoscopic surgery, Time to recurrence, Cancer specific survival

Core tip: This study presents a large cohort of patients operated on with laparoscopic complete mesocolic excisions (CME) for colonic cancer. Five-year survival data are presented. For the first time in a study on laparoscopic CME, it is shown that reoperation for an anastomotic leak has a negative impact on both unadjusted and adjusted survival analysis. The location of the tumour does not impact long-term survival.