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首页> 外文期刊>Surgical Endoscopy >Long-term oncologic outcomes after laparoscopic versus open rectal cancer resection: a high-quality population-based analysis in a Southern German district
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Long-term oncologic outcomes after laparoscopic versus open rectal cancer resection: a high-quality population-based analysis in a Southern German district

机译：腹腔镜和开放直肠癌切除后的长期肿瘤结果：在德国南部的基于高质量的人口分析

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Background An increasing number of rectal carcinoma resections in Germany and worldwide are performed laparoscopically. The recently published COLOR II trial demonstrated the oncologic safety of this surgical approach. It remains unclear whether these findings can be transferred to clinical practice. Patients and methods This population-based retrospective cohort study aimed to evaluate 5-year overall, relative, disease-free, and local recurrence-free survival of rectal cancer patients treated by open surgery and laparoscopy. Data from a southern German region of 1.1?million inhabitants were collected by an official clinical cancer registry. All primary non-metastatic rectal adenocarcinoma cases with surgery between 2004 and 2013 were eligible for inclusion. To compare survival rates, Kaplan–Meier analyses, relative survival models, and multivariate Cox regression were applied; a sensitivity analysis assessed bias by exclusion. Results Finally, 1507 patients with a median follow-up time of 7.1?years were included. Of these patients, 28.4% underwent laparoscopic procedures, with an increasing rate over time. Patients with tumors of the upper or middle rectum, younger patients, and patients of specialized colorectal cancer centers were more likely to undergo laparoscopy. After 5 years, 80.4% of laparoscopy patients were still alive, compared to 68.6% in the open group ( p ?
机译：背景技术德国和全球的越来越多的直肠癌切除在腹腔镜上进行。最近发表的Color II试验表明了这种手术方法的肿大安全性。尚不清楚这些发现是否可以转移到临床实践中。患者和方法该基于人口的回顾性队列队列的研究旨在评估通过开放式手术和腹腔镜检查的直肠癌患者的5年整体，相对，无病和局部复发存活。官方临床癌症登记处收集了德国南部地区1.1亿居民的数据。 2004年至2013年间手术的所有初级非转移性直肠腺癌病例有资格包含。为了比较生存率，应用Kaplan-Meier分析，相对生存模型和多变量Cox回归;敏感性分析通过排除评估偏差。结果最终，1507例中位后续时间为7.1？岁月的患者。在这些患者中，腹腔镜手术的28.4％，随着时间的推移而增加。患有上直肠或中直肠，患者的肿瘤，患者和专用结肠直肠癌中心的患者更有可能接受腹腔镜检查。 5年后，80.4％的腹腔镜检查患者仍然活着，相比开放组的68.6％（p？<0.001）。此外，腹腔镜检查与出色的局部复发存活率相关。该优点在多变量分析中也显着（HR 0.70,95％CI 0.52-0.92）。结论腹腔镜直肠癌手术可以在日常临床实践中被认为是安全的。这应该通过在随机试验的环境之外的未来研究证实。

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