Tratamento cirúrgico do adenocarcinoma de reto por laparoscopia e por acesso convencional: estudo comparativo de tempo cirúrgico, complicações pós-operatórias, radicalidade oncológica e sobrevida

• Autor(a) principal: Melani, Armando Geraldo Franchini
• Data de Publicação: 2011
• Outros Autores: Fregnani, José Humberto Tavares Guerreiro, Matos, Delcio [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• dARK ID: ark:/48912/0013000011298
• Texto Completo: http://dx.doi.org/10.1590/S0100-69912011000400008; http://repositorio.unifesp.br/handle/11600/6562
• topic: Colorectal surgery; Laparoscopy; Postoperative complications; Survival analysis; Colorectal neoplasms; Cirurgia colorretal; Laparoscopia; Complicações pós-operatórias; Análise de sobrevivência; Neoplasias colorretais

OBJECTIVE: To compare two surgical routes (laparoscopic and conventional) for the treatment of rectal cancer with regard to postoperative complications, oncological radicality and survival. METHODS: This is a retrospective study of 84 patients with rectal cancer who were admitted to the Barretos Cancer Hospital between 2000 and 2003. Only individuals who underwent elective operations with curative intent were included. The surgical approach was subjectively chosen rather than by location of the tumor. RESULTS: The laparoscopic access was used by 50% of patients. There was no difference (P> 0.05) between the two groups regarding age, sex, topography, staging, neoadjuvant and adjuvant treatment, number of dissected lymph nodes, size of surgical specimen, surgical margins, blood transfusions, postoperative complication rates, hospital stay and overall survival. Surgical time was longer in the laparoscopic group (median: 210x127, 5 min, P <0.001). A reduction in surgical time was noted with the increasing number of laparoscopies performed by the team (rho: -0.387, P = 0.020). CONCLUSION: The laparoscopic and conventional routes, for the treatment of rectal cancer, were equivalent with respect to postoperative complications, oncological radicality and survival. However, the operative time was longer in the laparoscopic group.