Laparoscopy in the surgical treatment of rectal cancer in Germany 2000-2009
Aim The goal of this registry study was to compare open surgery with planned laparoscopy and then with laparoscopic to open conversion for rectal cancer surgery. Method The study included 17 964 rectal cancer patients, operated on between 1 January 2000 and 31 December 2009, from 345 hospitals in...
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| Veröffentlicht in: | Colorectal disease 2012-12, Vol.14 (12), p.1473-1478 |
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| creator | Mroczkowski, P. Hac, S. Smith, B. Schmidt, U. Lippert, H. Kube, R. |
| description | Aim The goal of this registry study was to compare open surgery with planned laparoscopy and then with laparoscopic to open conversion for rectal cancer surgery.
Method The study included 17 964 rectal cancer patients, operated on between 1 January 2000 and 31 December 2009, from 345 hospitals in Germany. All statistical tests were two‐sided, with the χ2 test (Pearson correlation) for patients and tumour characteristics. Fisher’s exact test was used for complications and 30‐day mortality.
Results Of the 17 964 rectal cancer patients, 16 308 (90.8%) had an open procedure and 1656 (9.2%) were started with a laparoscopy. The 1455 patients with completed laparoscopic operations had fewer intra‐operative and postoperative complications (5.4%vs 7.0%, P = 0.020, and 20.5%vs 25.8%, P |
| doi_str_mv | 10.1111/j.1463-1318.2012.03058.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1179505325</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1179505325</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5248-9463d02a22bc02d9aee77576ad62fc8083cac2b031e51eeac18112a7c9a609323</originalsourceid><addsrcrecordid>eNqNkE1vEzEQhi0EoqXlL6A9ctllxo7X3gsSLJBWRO0FCjdr4kxgw36k9kYk_x5vU3KuD_bI8847M48QGUKB6bzbFDgrVY4KbSEBZQEKtC32z8T5KfH8IZa5rRDOxKsYNwBYGrQvxZmUegZWmXPxdUFbCkP0w_aQNX02_uYs7sKvxlObjYFp7Lgfs2GdBfZj-vPUew6TdM6ho_6QSQDI01VdihdraiO_fnwvxPcvn7_VV_nidn5df1jkXsuZzas04QokSbn0IFcVMRujTUmrUq69TXN58nIJClkjM3m0iJKMr6iESkl1Id4efbdhuN9xHF3XRM9tSz0Pu-gQTaVBK6mT1B6lPu0YA6_dNjQdhYNDcBNKt3ETMTcRcxNK94DS7VPpm8cuu2XHq1Phf3ZJ8P4o-Nu0fHiysatvP11PYTLIjwZNHHl_MqDwx5VGGe1-3MxdrW3986O9c1fqH6orjts</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1179505325</pqid></control><display><type>article</type><title>Laparoscopy in the surgical treatment of rectal cancer in Germany 2000-2009</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Mroczkowski, P. ; Hac, S. ; Smith, B. ; Schmidt, U. ; Lippert, H. ; Kube, R.</creator><creatorcontrib>Mroczkowski, P. ; Hac, S. ; Smith, B. ; Schmidt, U. ; Lippert, H. ; Kube, R.</creatorcontrib><description>Aim The goal of this registry study was to compare open surgery with planned laparoscopy and then with laparoscopic to open conversion for rectal cancer surgery.
Method The study included 17 964 rectal cancer patients, operated on between 1 January 2000 and 31 December 2009, from 345 hospitals in Germany. All statistical tests were two‐sided, with the χ2 test (Pearson correlation) for patients and tumour characteristics. Fisher’s exact test was used for complications and 30‐day mortality.
Results Of the 17 964 rectal cancer patients, 16 308 (90.8%) had an open procedure and 1656 (9.2%) were started with a laparoscopy. The 1455 patients with completed laparoscopic operations had fewer intra‐operative and postoperative complications (5.4%vs 7.0%, P = 0.020, and 20.5%vs 25.8%, P < 0.001, respectively) and a lower 30‐day mortality rate (1.1%vs 1.9%, P = 0.023). Of the 1656 planned laparoscopies, 201 (12.1%) were converted to open. The converted group suffered more intra‐operative complications (18.9%vs 3.6% for completed laparoscopy and 7.0% for open surgery, P < 0.0001) and postoperative complications (32.3%vs 18.9% for completed laparoscopy and 25.8% for open operations, P < 0.0001). The converted group also had a higher 30‐day mortality rate (2.0%vs 1.0% for completed laparoscopy and 1.9% for open surgery, P = 0.043).
Conclusion The more favourable patient profile provided justification for a laparoscopic procedure. For those converted to an open procedure, however, there were significantly more complications than planned open surgery patients. A move away from the standard open procedure for rectal cancer surgery and towards laparoscopy is not yet feasible.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/j.1463-1318.2012.03058.x</identifier><identifier>PMID: 22540837</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Aged ; Chi-Square Distribution ; Female ; Germany - epidemiology ; Humans ; Intraoperative Complications - epidemiology ; Laparoscopy ; Male ; Operative Time ; outcome control ; Rectal cancer ; Rectal Neoplasms - mortality ; Rectal Neoplasms - pathology ; Rectal Neoplasms - surgery ; Retrospective Studies ; surgery</subject><ispartof>Colorectal disease, 2012-12, Vol.14 (12), p.1473-1478</ispartof><rights>2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland</rights><rights>2012 The Authors. Colorectal Disease © 2012 The Association of Coloproctology of Great Britain and Ireland.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5248-9463d02a22bc02d9aee77576ad62fc8083cac2b031e51eeac18112a7c9a609323</citedby><cites>FETCH-LOGICAL-c5248-9463d02a22bc02d9aee77576ad62fc8083cac2b031e51eeac18112a7c9a609323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1463-1318.2012.03058.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1463-1318.2012.03058.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22540837$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mroczkowski, P.</creatorcontrib><creatorcontrib>Hac, S.</creatorcontrib><creatorcontrib>Smith, B.</creatorcontrib><creatorcontrib>Schmidt, U.</creatorcontrib><creatorcontrib>Lippert, H.</creatorcontrib><creatorcontrib>Kube, R.</creatorcontrib><title>Laparoscopy in the surgical treatment of rectal cancer in Germany 2000-2009</title><title>Colorectal disease</title><addtitle>Colorectal Dis</addtitle><description>Aim The goal of this registry study was to compare open surgery with planned laparoscopy and then with laparoscopic to open conversion for rectal cancer surgery.
Method The study included 17 964 rectal cancer patients, operated on between 1 January 2000 and 31 December 2009, from 345 hospitals in Germany. All statistical tests were two‐sided, with the χ2 test (Pearson correlation) for patients and tumour characteristics. Fisher’s exact test was used for complications and 30‐day mortality.
Results Of the 17 964 rectal cancer patients, 16 308 (90.8%) had an open procedure and 1656 (9.2%) were started with a laparoscopy. The 1455 patients with completed laparoscopic operations had fewer intra‐operative and postoperative complications (5.4%vs 7.0%, P = 0.020, and 20.5%vs 25.8%, P < 0.001, respectively) and a lower 30‐day mortality rate (1.1%vs 1.9%, P = 0.023). Of the 1656 planned laparoscopies, 201 (12.1%) were converted to open. The converted group suffered more intra‐operative complications (18.9%vs 3.6% for completed laparoscopy and 7.0% for open surgery, P < 0.0001) and postoperative complications (32.3%vs 18.9% for completed laparoscopy and 25.8% for open operations, P < 0.0001). The converted group also had a higher 30‐day mortality rate (2.0%vs 1.0% for completed laparoscopy and 1.9% for open surgery, P = 0.043).
Conclusion The more favourable patient profile provided justification for a laparoscopic procedure. For those converted to an open procedure, however, there were significantly more complications than planned open surgery patients. A move away from the standard open procedure for rectal cancer surgery and towards laparoscopy is not yet feasible.</description><subject>Aged</subject><subject>Chi-Square Distribution</subject><subject>Female</subject><subject>Germany - epidemiology</subject><subject>Humans</subject><subject>Intraoperative Complications - epidemiology</subject><subject>Laparoscopy</subject><subject>Male</subject><subject>Operative Time</subject><subject>outcome control</subject><subject>Rectal cancer</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>surgery</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1vEzEQhi0EoqXlL6A9ctllxo7X3gsSLJBWRO0FCjdr4kxgw36k9kYk_x5vU3KuD_bI8847M48QGUKB6bzbFDgrVY4KbSEBZQEKtC32z8T5KfH8IZa5rRDOxKsYNwBYGrQvxZmUegZWmXPxdUFbCkP0w_aQNX02_uYs7sKvxlObjYFp7Lgfs2GdBfZj-vPUew6TdM6ho_6QSQDI01VdihdraiO_fnwvxPcvn7_VV_nidn5df1jkXsuZzas04QokSbn0IFcVMRujTUmrUq69TXN58nIJClkjM3m0iJKMr6iESkl1Id4efbdhuN9xHF3XRM9tSz0Pu-gQTaVBK6mT1B6lPu0YA6_dNjQdhYNDcBNKt3ETMTcRcxNK94DS7VPpm8cuu2XHq1Phf3ZJ8P4o-Nu0fHiysatvP11PYTLIjwZNHHl_MqDwx5VGGe1-3MxdrW3986O9c1fqH6orjts</recordid><startdate>201212</startdate><enddate>201212</enddate><creator>Mroczkowski, P.</creator><creator>Hac, S.</creator><creator>Smith, B.</creator><creator>Schmidt, U.</creator><creator>Lippert, H.</creator><creator>Kube, R.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201212</creationdate><title>Laparoscopy in the surgical treatment of rectal cancer in Germany 2000-2009</title><author>Mroczkowski, P. ; Hac, S. ; Smith, B. ; Schmidt, U. ; Lippert, H. ; Kube, R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5248-9463d02a22bc02d9aee77576ad62fc8083cac2b031e51eeac18112a7c9a609323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Aged</topic><topic>Chi-Square Distribution</topic><topic>Female</topic><topic>Germany - epidemiology</topic><topic>Humans</topic><topic>Intraoperative Complications - epidemiology</topic><topic>Laparoscopy</topic><topic>Male</topic><topic>Operative Time</topic><topic>outcome control</topic><topic>Rectal cancer</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - surgery</topic><topic>Retrospective Studies</topic><topic>surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mroczkowski, P.</creatorcontrib><creatorcontrib>Hac, S.</creatorcontrib><creatorcontrib>Smith, B.</creatorcontrib><creatorcontrib>Schmidt, U.</creatorcontrib><creatorcontrib>Lippert, H.</creatorcontrib><creatorcontrib>Kube, R.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mroczkowski, P.</au><au>Hac, S.</au><au>Smith, B.</au><au>Schmidt, U.</au><au>Lippert, H.</au><au>Kube, R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopy in the surgical treatment of rectal cancer in Germany 2000-2009</atitle><jtitle>Colorectal disease</jtitle><addtitle>Colorectal Dis</addtitle><date>2012-12</date><risdate>2012</risdate><volume>14</volume><issue>12</issue><spage>1473</spage><epage>1478</epage><pages>1473-1478</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>Aim The goal of this registry study was to compare open surgery with planned laparoscopy and then with laparoscopic to open conversion for rectal cancer surgery.
Method The study included 17 964 rectal cancer patients, operated on between 1 January 2000 and 31 December 2009, from 345 hospitals in Germany. All statistical tests were two‐sided, with the χ2 test (Pearson correlation) for patients and tumour characteristics. Fisher’s exact test was used for complications and 30‐day mortality.
Results Of the 17 964 rectal cancer patients, 16 308 (90.8%) had an open procedure and 1656 (9.2%) were started with a laparoscopy. The 1455 patients with completed laparoscopic operations had fewer intra‐operative and postoperative complications (5.4%vs 7.0%, P = 0.020, and 20.5%vs 25.8%, P < 0.001, respectively) and a lower 30‐day mortality rate (1.1%vs 1.9%, P = 0.023). Of the 1656 planned laparoscopies, 201 (12.1%) were converted to open. The converted group suffered more intra‐operative complications (18.9%vs 3.6% for completed laparoscopy and 7.0% for open surgery, P < 0.0001) and postoperative complications (32.3%vs 18.9% for completed laparoscopy and 25.8% for open operations, P < 0.0001). The converted group also had a higher 30‐day mortality rate (2.0%vs 1.0% for completed laparoscopy and 1.9% for open surgery, P = 0.043).
Conclusion The more favourable patient profile provided justification for a laparoscopic procedure. For those converted to an open procedure, however, there were significantly more complications than planned open surgery patients. A move away from the standard open procedure for rectal cancer surgery and towards laparoscopy is not yet feasible.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>22540837</pmid><doi>10.1111/j.1463-1318.2012.03058.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Chi-Square Distribution Female Germany - epidemiology Humans Intraoperative Complications - epidemiology Laparoscopy Male Operative Time outcome control Rectal cancer Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - surgery Retrospective Studies surgery |
| title | Laparoscopy in the surgical treatment of rectal cancer in Germany 2000-2009 |
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