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Early oncological predictros of laparoscopic surgery for treatment in patients with colorectal carcinoma
Hirurška klinika, Kliničko bolnički centar Zemun , Beograd , Serbia
Hirurška klinika, Kliničko bolnički centar Zemun , Beograd , Serbia
Medicinski fakultet u Beogradu, University of Belgrade , Belgrade , Serbia
Hirurška klinika, Kliničko bolnički centar Zemun , Beograd , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Hirurška klinika, Kliničko bolnički centar Zemun , Beograd , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Hirurška klinika, Kliničko bolnički centar Zemun , Beograd , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Medical Faculty of Belgrade, University of Belgrade , Belgrade , Serbia
Published: 01.12.2020.
Volume 36, Issue 3 (2020)
pp. 1913-1921;
Abstract
The debate of proponents of laparoscopic and classical colorectal surgery is still ongoing, especially on the oncological principles of colorectal malignancy treatment. For now, there are promising results in terms of the adequacy of laparoscopic surgery in the treatment of this disease. The study involved 60 patients with acceptable generalized operability and a diagnostically verified malignant neoplasm of colorectum. Patients were divided into two groups of 30 patients: patients who were operated with open and laparoscopically assisted colorectal surgery. Two groups of factors were collected and analyzed for all patients. The first group of factors was known preoperatively and the second group of factors was known postoperatively. There was no significant differences between the two groups concerning the age, sex, ASA score, preoperative hemoglobin values, blood type. Both groups were the most represented in the rectum cancer. The largest number of patients was G2 grade 49.1%. Surgical margins were negative for cancer in all examined patients. There was a statistically significant difference, in terms of a larger number of removed lymph glands in open surgery treated patients. The average number of lymph nodes removed laparoscopically was 14 (range 5-40), while in the classic-open group number was 20 (range 8-44). Laparoscopic group were able to retrieve >12 LNs in 70% of the cases while in classic-open group were able to retrieve >12 LNs in 93% of the cases. The third stage of the disease was significantly more prevalent in the classical group of patients than in laparoscopic group of patients (17: 7 patients). The average volume of the removed tumor in the laparoscopic group is 73 cm3, while in the classical group the average volume is 99 cm3. Our results show that classic-open and laparoscopic approaches in colorectal cancer surgery are associated with the retrieval of greater than 12 LNs, therefore both are adeqate for safe oncological treatment of this disease. With classic-open colorectal surgery, we are still able to retrive more matching LNs, compared to laparoscopic surgery.
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