Long-term results after laparoscopic resection of colorectal carcinoma

Background: Laparoscopic techniques are currently used for curative resection of colorectal cancer although long-term results from controlled clinical trials are not available yet that prove laparoscopic procedures are adequate. Methods: All patients who underwent a curative resection of a colorectal tumor from 1995 to 1997 were included in a prospective cohort study to evaluate the short- and long-term results. Results: Laparoscopic colorectal resections were accomplished in 68 patients. In only 3 patients was an adenoma (stage 0) found, and 10 patients had multiple liver metastases at the time of palliative resection. An oncological resection was performed in 55 patients. The average age was 62.8 +/- 14.6 years (29 female and 26 male patients). Eleven right colectomies, 1 left colectomy, 21 sigmoid resections, 16 proctosigmoidectomies and 6 abdominoperineal resections were carried out. Two patients (3.6%) were lost during follow-up. The median follow-up was 27.1 months (range 9.1-45.1 months). No port-site metastases were found. Two patients who are still alive after sigmoid resection suffered from a recurrence. The first patient underwent only limited lymphadenectomy because of synchronous malignant lymphoma. The second patient developed bilateral lung metastases. Only one patient died during the follow-up period because of myocardial infarction. Conclusion: Although the follow-up is short, it seems that the recurrence rate is low. Controlled multicenter clinical trials are currently performed to evaluate whether laparoscopic surgery is really adequate to treat colorectal cancer.