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Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques

INTRODUCTION: Laparoscopic colectomy is considered with increasing frequency the gold standard treatment for colorectal cancer. Our study aims to show that short-term results and the oncological safety of laparoscopy are at least equivalent to those of laparotomy in the treatment of non-metastatic c...

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Autores principales: Bayar, Rached, Mzoughi, Zeineb, Djebbi, Achref, Halek, Ghassen, Khalfallah, Mohamed Taher
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The African Field Epidemiology Network 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326039/
https://www.ncbi.nlm.nih.gov/pubmed/28292127
http://dx.doi.org/10.11604/pamj.2016.25.165.10071
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author Bayar, Rached
Mzoughi, Zeineb
Djebbi, Achref
Halek, Ghassen
Khalfallah, Mohamed Taher
author_facet Bayar, Rached
Mzoughi, Zeineb
Djebbi, Achref
Halek, Ghassen
Khalfallah, Mohamed Taher
author_sort Bayar, Rached
collection PubMed
description INTRODUCTION: Laparoscopic colectomy is considered with increasing frequency the gold standard treatment for colorectal cancer. Our study aims to show that short-term results and the oncological safety of laparoscopy are at least equivalent to those of laparotomy in the treatment of non-metastatic colic adenocarcinomas. We also highlight the impact of the learning curve on outcomes after laparoscopy in patients with these cancers. METHODS: We conducted a retrospective study of all patients undergoing surgery for resectable colic adenocarcinomas over a period of 6 years. The study population was divided into 2 groups based on the surgical procedure used initially. The group “OC“ included 35 patients who underwent midline laparotomy and the group “LAC” included 30 patients who underwent laparoscopy. All data were analyzed using SPSS software version 19.0. RESULTS: Our study showed that there was no significant difference in short-term outcomes between the 2 groups, namely intraoperative morbidity, hospital stay, intensive care unit stay as well as postoperative morbidity and mortality. Regarding the long-term outcomes, there was also no significant difference in the incidence of late complications, type of recurrence, overall survival and disease-free survival. Oncological safety based on the limits of resection and the number of lymph nodes removed was not significantly different between the two groups. Operative time was significantly longer in the laparoscopic group (p <0.001). Convertion rate was 33%. It went from 67% in the first 2 years of the study to 13% in the last 2 years. The conversion from laparoscopy to laparotomy had no significant impact neither on early postoperative outcomes nor on overall survival and disease-free survival. CONCLUSION: Laparoscopy is a surgical procedure resulting in at least equivalent short and long term outcomes as laparotomy. The learning curve representing a “prerequisite” has no negative impact on the outcomes of laparoscopic treatment of non-metastatic colic cancers.
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spelling pubmed-53260392017-03-10 Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques Bayar, Rached Mzoughi, Zeineb Djebbi, Achref Halek, Ghassen Khalfallah, Mohamed Taher Pan Afr Med J Research INTRODUCTION: Laparoscopic colectomy is considered with increasing frequency the gold standard treatment for colorectal cancer. Our study aims to show that short-term results and the oncological safety of laparoscopy are at least equivalent to those of laparotomy in the treatment of non-metastatic colic adenocarcinomas. We also highlight the impact of the learning curve on outcomes after laparoscopy in patients with these cancers. METHODS: We conducted a retrospective study of all patients undergoing surgery for resectable colic adenocarcinomas over a period of 6 years. The study population was divided into 2 groups based on the surgical procedure used initially. The group “OC“ included 35 patients who underwent midline laparotomy and the group “LAC” included 30 patients who underwent laparoscopy. All data were analyzed using SPSS software version 19.0. RESULTS: Our study showed that there was no significant difference in short-term outcomes between the 2 groups, namely intraoperative morbidity, hospital stay, intensive care unit stay as well as postoperative morbidity and mortality. Regarding the long-term outcomes, there was also no significant difference in the incidence of late complications, type of recurrence, overall survival and disease-free survival. Oncological safety based on the limits of resection and the number of lymph nodes removed was not significantly different between the two groups. Operative time was significantly longer in the laparoscopic group (p <0.001). Convertion rate was 33%. It went from 67% in the first 2 years of the study to 13% in the last 2 years. The conversion from laparoscopy to laparotomy had no significant impact neither on early postoperative outcomes nor on overall survival and disease-free survival. CONCLUSION: Laparoscopy is a surgical procedure resulting in at least equivalent short and long term outcomes as laparotomy. The learning curve representing a “prerequisite” has no negative impact on the outcomes of laparoscopic treatment of non-metastatic colic cancers. The African Field Epidemiology Network 2016-11-16 /pmc/articles/PMC5326039/ /pubmed/28292127 http://dx.doi.org/10.11604/pamj.2016.25.165.10071 Text en © Rached Bayar et al. http://creativecommons.org/licenses/by/2.0/ The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Bayar, Rached
Mzoughi, Zeineb
Djebbi, Achref
Halek, Ghassen
Khalfallah, Mohamed Taher
Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
title Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
title_full Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
title_fullStr Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
title_full_unstemmed Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
title_short Colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
title_sort colectomie laparoscopique versus colectomie par laparotomie dans le traitement des adénocarcinomes coliques non métastatiques
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5326039/
https://www.ncbi.nlm.nih.gov/pubmed/28292127
http://dx.doi.org/10.11604/pamj.2016.25.165.10071
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