Laparoscopic surgery for colon cancer: a systematic review.

INTRODUCTION Colorectal cancer is the second leading cause of cancer-related death in western countries. The objective of this systematic review was to show that laparoscopic-assisted colon resection for cancer is not inferior to open colectomy with respect to cancer survival and perioperative outcomes. METHOD We performed a comprehensive literature review. Inclusion criteria were adults aged over 16 years with a colon resection for documented colon cancer and randomized controlled trials with laparoscopic- assisted or open resections. We excluded studies that did not document colon cancer recurrence in their article. We assessed data extraction and study quality and performed a quantitative data analysis. RESULTS Six published and 4 unpublished studies fulfilled our inclusion criteria, with a total of 1262 patients. All primary and secondary outcomes showed good homogeneity, except for morbidity, which was described heterogeneously between the studies. There was no disadvantage to laparoscopic colon resection in any of these primary and secondary outcomes, compared with the conventional open technique. CONCLUSION The results of this study suggest that, although there is no definitive answer, present evidence indicates that laparoscopic colon cancer resection is as safe and efficacious as the conventional open technique.

[1]  N. Laird,et al.  Meta-analysis in clinical trials. , 1986, Controlled clinical trials.

[2]  D Rattner,et al.  Early results of laparoscopic surgery for colorectal cancer , 1996, Diseases of the colon and rectum.

[3]  J. Monson,et al.  Assessing the relative costs of standard open surgery and laparoscopic surgery in colorectal cancer in a randomised controlled trial in the United Kingdom. , 2000, Critical reviews in oncology/hematology.

[4]  H. Nelson,et al.  Laparoscopic colectomy for colon cancer: trial update. , 1998, Journal of surgical oncology.

[5]  H. Nelson,et al.  Proposed phase III trial comparing laparoscopic-assisted colectomy versus open colectomy for colon cancer. , 1995, Journal of the National Cancer Institute. Monographs.

[6]  J. Fleshman,et al.  A comparison of laparoscopically assisted and open colectomy for colon cancer. , 2004, The New England journal of medicine.

[7]  R. Rosenthal,et al.  Laparoscopic colectomy vs traditional colectomy for diverticulitis , 2007, Surgical Endoscopy.

[8]  J. Gama-Rodrigues,et al.  Conventional approach x laparoscopic abdominoperineal resection for rectal cancer treatment after neoadjuvant chemoradiation: results of a prospective randomized trial. , 2003, Revista do Hospital das Clinicas.

[9]  M. Guerrieri,et al.  Results of laparoscopic vs open resections for colon cancer in patients with a minimum follow-up of 3 years , 2002, Surgical Endoscopy And Other Interventional Techniques.

[10]  R. Rosenthal,et al.  Laparoscopic colectomy vs traditional colectomy for diverticulitis. Outcome and costs. , 1996, Surgical endoscopy.

[11]  J. Rombeau Functional Recovery After Open Versus Laparoscopic Colonic Resection: A Randomized, Blinded Study , 2006 .

[12]  S. Kwok,et al.  Prospective evaluation of laparoscopic-assisted large bowel excision for cancer. , 1996, Annals of surgery.

[13]  S. Papagrigoriadis Prospective randomized study of laparoscopic versus open colonic resection for adenocarcinoma. , 1997, The British journal of surgery.

[14]  H. Kehlet,et al.  Convalescence after Colonic Resection with Fast-Track versus Conventional Care , 2004, Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society.

[15]  V. Fazio,et al.  A prospective, randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. , 1998, Journal of the American College of Surgeons.

[16]  E. Campo,et al.  Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer , 1995, Surgical Endoscopy.

[17]  D. Rosenthal,et al.  Prospective comparison of openvs. laparoscopic colon surgery for carcinoma , 1996, Diseases of the colon and rectum.

[18]  M Jacobs,et al.  Minimally invasive colon resection (laparoscopic colectomy). , 1991, Surgical laparoscopy & endoscopy.

[19]  K. Zucker,et al.  Laparoscopically assisted colon resection for colon carcinoma: perioperative results and long-term outcome. , 2000, Surgical endoscopy.

[20]  J. Fleiss,et al.  The statistical basis of meta-analysis. , 1993, Statistical methods in medical research.

[21]  M. Guerrieri,et al.  Results of laparoscopic versus open resections for non-early rectal cancer in patients with a minimum follow-up of four years. , 2002, Hepato-gastroenterology.

[22]  Antoni Castells,et al.  Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial , 2002, The Lancet.

[23]  G. Kazemier,et al.  Subcutaneous metastases after laparoscopic colectomy , 1994, The Lancet.

[24]  B. Dousset,et al.  The Clinical Outcome of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon Cancer. N Engl J Med 2004;350:2050-2059 , 2004 .

[25]  Hazebroek Ej COLOR: a randomized clinical trial comparing laparoscopic and open resection for colon cancer. , 2002 .

[26]  L. Gellman,et al.  Laparoscopic assisted colectomy , 1996, Surgical Endoscopy.

[27]  M. Guerrieri,et al.  Laparoscopic vs open hemicolectomy for colon cancer , 2002, Surgical Endoscopy.