Resección laparoscópica en cáncer de recto etapa III: ¿mejor de lo que esperábamos?

Abstract

Laparoscopic Resection in Stage III Rectal Cancer: Better than we expected?Introduction: Laparoscopic approach to management of rectal cancer (CR) has shown similar results compared to conventional technique. In some series, patients in stage III showed a better survival function in laparoscopic approach. The aim of this study is to compare disease specific survival (SE) and disease free survival (SLE) in patients with stage III rectal cancer treated with radical surgery via laparoscopy or laparotomy. Method: Historic cohort study, all stage III patients treated with elective radical surgery for CR in the period between August 2005 and May 2012 were included. Demographic, surgical specimens and survivor function for SE and SLE were compared. Results: A total of 51 patients were included, 29 laparoscopic and 22 open. The groups were similar in demographic data. Number of lymph nodes, compromised lymph nodes and distal margin distance was significantly higher in the open approach. The percentage of low lymph node count was 9.1% in the open group and 34.5% in the laparoscopic group (p = 0.03). SE estimated at 5 years was 50% and 80% in the open and laparoscopic approach respectively (p = 0.019). On multivariate analysis, laparoscopic approach was an independent factor for better SE and SLE. Tumor size was an independent risk factor for poor SLE. Conclusion: In our series, laparoscopic approach would be and independent factor for better survival in patients with stage III CR. Tumor size would be associated with poor SLE.

Estándares De Calidad en Cirugía Colorrectal

“…De hecho, varias publicaciones nacionales señalan expresamente el tipo de estudio realizado a sus pacientes, la toma de decisiones en un equipo multidisciplinario (Comité Oncológico), la neoadyuvancia en cáncer de recto y el tipo de cirugía realizada, el protocolo del estudio histopatológico de la pieza quirúrgica, así como los resultados inmediatos y alejados en términos de recidiva y sobrevivencia [11][12][13][14][15][16] . En la Tabla 2 se muestra los indicadores utilizados en el HCSBA, hospital público docente como un insumo, para la discusión y enriquecimiento del tema, lo que podría ser abordado en el seno de la Sociedad Chilena de Coloproctología.…”