Objective: Laparoscopic colorectal cancer (CRC) surgery has increasingly become the standard of care world-wide. However, the availability within the rural Western Australian setting remains heterogenous and the long term outcome is largely unknown. This study reviews our experience and 5 year outcomes in laparoscopic colorectal cancer surgery (CRC) in a major rural surgical unit in Western Australia.
Materials and Methods: This is a retrospective study based in Albany Regional Hospital, Western Australia. All patients who underwent elective laparoscopic colorectal surgery for cancer by a single surgeon over a five-year period (2007- 2012) were included. All case records were reviewed. All cases had been discussed in multidisciplinary meeting and recommendations were followed in regards to staging modalities and / or neo-adjuvant and adjuvant treatments. Patients were followed up in the surgical clinic six monthly with serial CEA and a yearly CT Chest, abdomen and pelvis and colonoscopy as per guidelines, thereafter they were discharged for GP follow. The primary outcomes were local recurrence, metastatic disease, five year disease free survival, anastomotic stricture, incisional hernia and small bowel obstruction.
Results: Sixty-seven patients were reviewed. Two required conversion to open (3%) and were not considered further. A total of 65 patients were included (30 male, mean age: 69 years). The most common site of tumour was at the ascending colon which comprised of 38% of all cases. The mean operating time was 161 minutes. Five year disease free survival was 97%, no Local recurrence of anastomotic strictures were detected in our study, The overall cancer related mortality was one case out of the 65 cases.
Conclusions: Laparoscopic colorectal cancer surgery is safe and feasible in the rural Western Australian setting with comparable 5 year outcomes with international literature. Provided this is performed by appropriately trained general surgeons with suitable case selection.
Endoscopic follow-up after colorectal cancer surgery. Early detection of local recurrence?