Five-year recurrence and postoperative complications after laparoscopic complete Mesocolic excision: A...

Area of Science:

• Colorectal surgery
• Surgical oncology
• Minimally invasive surgery

Background:

• Laparoscopic Complete Mesocolic Excision (LCME) benefits are debated due to study limitations.
• This study evaluated LCME's impact on recurrence and complications in a population-based setting.

Purpose of the Study:

• To assess the 5-year recurrence risk after LCME implementation.
• To evaluate 30-day postoperative complications before and after LCME adoption.

Main Methods:

• LCME was implemented across the Central Denmark Region following a surgeon training program.
• Colon cancer patient data (2015-2019) were analyzed from the Danish Colorectal Cancer Group Database.
• Recurrence was tracked via national registers; the Aalen-Johansen estimator calculated cumulative incidence.

Main Results:

• The 5-year recurrence incidence decreased from 16.1% (PRE) to 12.5% (POST) after LCME implementation.
• A significant reduction in recurrence hazard rate was observed in stage II patients (HR 0.42).
• Severe postoperative complications were significantly lower in the POST group compared to the PRE group.

Conclusions:

• Multicentre LCME implementation is associated with reduced colon cancer recurrence.
• LCME adoption led to a significant decrease in severe postoperative complications.
• Population-based LCME implementation can improve oncological outcomes and patient safety.