Colorectal cancer surgery: a french survey of more than 84 000 patients: OP03

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Aim:This study aimed to identify risk-factors of mortality after colorectal cancer resection in France, with special reference to the impact of laparoscopic approach.Method:Data were extracted from the French national health service database (Programme de Médicalisation des Syste`mes d'Information, PMSI). All patients who underwent colorectal resection for colorectal cancer between 2006 and 2008 in France were included. A multivariate analysis evaluating risk-factors for post-operative 30-day mortality was performed including the following factors: age, gender, tumour location, associated co-morbidities, emergency surgery, synchronous liver metastasis, and surgical approach.Results:A total of84 524 patients were included: 22 359 with laparoscopic approach (27%) and 62 165 with open approach (73%). From 2006 to 2008, laparoscopic approach rate increased from 23% to 26%. Postoperative 30-day mortality was 5.0%. In multivariate analysis, independent factors influencing mortality were: age ≥ 70 years (OR: 3.3), respiratory comorbidity (3.2), vascular comorbidity (2.7), synchronous liver metastasis (2.7), neurologic comorbidity (1.8), and laparoscopic approach (0.6).Conclusion:For the first time, a national survey including all patients undergoing colorectal resection for cancer during a 3-year period suggested that laparoscopic approach could significantly reduce post-operative mortality. This result might support better acceptance and widespread of laparoscopic approach in colorectal cancer.

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