부산대학교 도서관

Byline: C. A. Bertelsen, A. U. Neuenschwander, J. E. Jansen, A. Kirkegaard-Klitbo, J. R. Tenma, M. Wilhelmsen, L. A. Rasmussen, L. V. Jepsen, B. Kristensen, I. Gogenur, the Copenhagen Complete Mesocolic Excision Study (COMES), the Danish Colorectal Cancer Group (DCCG), B. Bols, P. Ingeholm, E. R. Iversen Background Complete mesocolic excision (CME) seems to be associated with improved oncological outcomes compared with 'conventional' surgery, but there is a potential for higher morbidity. Methods Data for patients after elective resection at the four centres in the Capital Region of Denmark (June 2008 to December 2013) were retrieved from the Danish Colorectal Cancer Group database and medical charts. Approval from a Danish ethics committee was not required (retrospective study). Results Some 529 patients who underwent CME surgery at one centre were compared with 1701 patients undergoing 'conventional' resection at the other three hospitals. Laparoscopic CME was performed in 258 (48ae8 per cent) and laparoscopic 'conventional' resection in 1172 (68ae9 per cent). More extended right colectomy procedures were done in the CME group (17ae4 versus 3ae6 per cent). The 90-day mortality rate in the CME group was 6ae2 per cent versus 4ae9 per cent in the 'conventional' group (P=0ae219), with a propensity score-adjusted logistic regression odds ratio (OR) of 1ae22 (95 per cent c.i. 0ae79 to 1ae87). Laparoscopic surgery was associated with a lower risk of mortality at 90days (OR 0ae63, 0ae42 to 0ae95). Intraoperative injury to other organs was more common in CME operations (9ae1 per cent versus 3ae6 per cent for 'conventional' resection; P Conclusion CME is associated with more intraoperative organ injuries and severe non-surgical complications than 'conventional' resection for colonic cancer.