Laparoscopic @entity348 ( XXXX ) for @entity5 surgery: long-term outcomes.

@entity1 @entity5493 @entity5 @entity957 @entity348 @entity14 @entity1141
BACKGROUND: @entity348 ( @entity348 ) offers the lowest reported rates of local recurrence and the best survival results in @entity1 with @entity5 . However, the laparoscopic approach to resection for @entity14 remains controversial due to fears that oncologic principles will be compromised. We assessed the feasibility, safety and long-term outcome of @entity5 resections following the principles of @entity348 . The aim of this study was to evaluate the perioperative outcome and long-term results of laparoscopic @entity348 . METHODS: We reviewed the prospective database of 102 consecutive unselected @entity1 undergoing laparoscopic @entity348 for @entity5 between November 1991 and December 2000. Follow-up was done through office charts or direct @entity1 contact. Recurrence and survival curves were generated by the Kaplan-Meier method. RESULTS: Laparoscopic @entity348 was completed successfully in 99 @entity1 , whereas conversion to an open approach was required in three cases (3%). The overall morbidity and mortality rates were 27% and 2%, respectively, with an overall anastomotic leak rate of 17%. Of the 102 @entity1 , four were excluded from the oncologic evaluation because final pathology was not confirmatory (two had anal @entity957 and two had @entity5493 with @entity1141 ). In 90 of the 98 remaining @entity1 (91.8%), the resection was considered curative. The remainder had a palliative resection due to synchronous metastatic disease or locally advanced disease. Mean follow-up was 36 months (range, 6-96). There were no trocar site recurrences. The local recurrence rate was 6%, and the @entity5 -specific survival of all curatively resected @entity1 was 75% at 5 years. The overall survival rate of all curatively resected @entity1 was 65% at 5 years; mean survival time was 6.23 years (95% confidence interval [CI], 5.39-7.07). CONCLUSION: Laparoscopic @entity348 is feasible and safe. The laparoscopic approach to the surgical treatment of operable @entity5 does not seem to entail any oncologic disadvantages.
