Waard, D.D. (2012) Oncological safety of laparoscopic versus open surgical procedures in colorectal cancer; a retrospective cohort study of the total Dutch population. thesis, Medicine.
Full text available on request.Abstract
Introduction: Laparoscopic surgery for colorectal malignancies is growing in popularity rapidly. Benefits in short-term results have been proven for laparoscopic surgery. However, long-term oncological results of laparoscopic surgery remain controversial. Several studies suggested similar results for open versus laparoscopic surgery, but study populations were small and performed in dedicated laparoscopic centres. The aim of this study was to offer a realistic view of differences in results between open and laparoscopic surgery for colorectal surgery in everyday practice in the Netherlands. Methods: A retrospective cohort study was performed among the total Dutch population. Data were obtained from the NKR and PALGA databases. Between January 2008 and January 2010 a total of 18.156 patients underwent primary resection of their colorectal malignancy and were included in the study. The key endpoints of the study, disease free survival and peritoneal carcinomatosis free survival, were analysed with Kaplan-Meier curves and Cox proportional hazards analyses. Results: A total of 13.148 (72.4%) underwent open- and 5008 (27.6%) underwent laparoscopic surgery. Baseline patient and tumour characteristics were similar between the two groups. Mean follow-up time was almost 2 years. Kaplan Meier analyses indicated significant poorer DFS and PC-free survival in the open group. Cox proportional hazards analyses supported these results. Results were regardless of disease stadium or localisation. Conclusion: Laparoscopic surgery for colorectal malignancies in everyday practice is safe regarding long-term oncological results and has significantly higher DFS and PC-free survival than open surgery. Further research should indentify subgroups of patients in which laparoscopic surgery should become standard treatment.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Bosker, Dr. R.J.I. surgeon |
| Supervisor name: | External supervisor: and Aalbers, Drs. A.G.J. surgeon |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:50 |
| Last Modified: | 25 Jun 2020 10:50 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1081 |
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