Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer

The authors examined the impact of the laparoscopic approach on the early outcome of resected colon carcinomas. The role of laparoscopic techniques in the treatment of colon carcinomas is questionable. Previous studies have suggested technical feasibility of surgical resections of these cancers by laparoscopic means and have implied a benefit to laparoscopic technique for patients undergoing colorectal resections. A prospective, randomized study was conducted comparing laparoscopic assisted colectomy (LAC) open colectomy (OC) for colon cancer. We present the preliminary results in relation to the short-term outcome and judge the feasibility of the laparoscopic procedure to as a way of performing accurate oncologic resection and staging. Benefit has been demonstrated with LAC in this setting. Passing flatus, oral intake, and discharge from hospital occurred earlier in LAC- than OC-treated patients The mean operative time was significantly longer in the LAC group than in the OC group. The overall morbidity was significantly lower in the LAC group. No significant differences were observed between both groups in the number of lymph nodes removed or the pathological stage following the Astler-Coller modification of the Dukes classification. The laparoscopic approach improves the short-term outcome of segmental colectomies for colon cancer. However, the further follow-up of these patients will allow us to answer in the near future whether or not the LAC may influence the long-term outcome.

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

[2]  S. Wexner,et al.  Laparoscopic colorectal resection for cancer: the Cleveland Clinic Florida experience. , 1993, Surgical oncology.

[3]  R. Beart,et al.  Laparoscopy and colon cancer. Is the port site at risk? A preliminary report. , 1994, Archives of surgery.

[4]  A. Darzi,et al.  Prospective evaluation of laparoscopic-assisted colectomy in an unselected group of patients , 1992, The Lancet.

[5]  M. A. Fusco,et al.  Abdominal wall recurrence after laparoscopic-assisted colectomy for adenocarcinoma of the colon , 1993, Diseases of the colon and rectum.

[6]  G. W. Snedecor Statistical Methods , 1964 .

[7]  A. Darzi,et al.  Experience with laparoscopic colorectal surgery for malignant disease. , 1993, Surgical oncology.

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

[9]  P. M. Falk,et al.  Laparoscopic colectomy: A critical appraisal , 1993, Diseases of the colon and rectum.

[10]  O. L. Davies,et al.  Statistical Methods. 6th Edition. , 1968 .

[11]  F. A. Coller,et al.  THE PROGNOSTIC SIGNIFICANCE OF DIRECT EXTENSION OF CARCINOMA OF THE COLON AND RECTUM , 1954, Annals of surgery.

[12]  F. Dubois,et al.  Cholécystectomie par coelioscopie , 1989 .

[13]  A Cuschieri,et al.  The European experience with laparoscopic cholecystectomy. , 1991, American journal of surgery.

[14]  A. Lacy,et al.  Is laparoscopic colectomy a safe procedure in synchronous colorectal carcinoma? Report of a case. , 1995, Surgical laparoscopy & endoscopy.

[15]  J. Sackier,et al.  Coelioscopic cholecystectomy. , 1990, Annals of surgery.

[16]  T. Wilson,et al.  Subcutaneous metastases after laparoscopic resection of malignancy. , 1993, The Australian and New Zealand journal of surgery.

[17]  L. G. Henry,et al.  Laparoscopically assisted colon resections compare favorably with open technique. , 1994, Surgical laparoscopy & endoscopy.

[18]  R. Schlinkert Laparoscopic-assisted right hemicolectomy , 1991, Diseases of the colon and rectum.

[19]  B. Jaques,et al.  Laparoscopically assisted colectomy and wound recurrence , 1993, The Lancet.

[20]  J. Nogueras,et al.  Laparoscopic total abdominal colectomy , 1992, Diseases of the colon and rectum.

[21]  R. Beart Laparoscopic colectomy: Status of the art , 1994, Diseases of the Colon & Rectum.

[22]  F. DUBOIS,et al.  Coelioscopic Cholecystectomy: Preliminary Report of 36 Cases , 1990, Annals of surgery.

[23]  J. Nogueras,et al.  Laparoscopic colorectal surgery: A prospective assessment and current perspective , 1993, The British journal of surgery.

[24]  R. Grace,et al.  Detection of lymph node metastases in colorectal carcinoma before and after fat clearance , 1989, The British journal of surgery.

[25]  D. Olsen,et al.  Laparoscopic laser cholecystectomy , 2004, Surgical Endoscopy.

[26]  N. O’Rourke,et al.  Laparoscopic surgery for colorectal cancer , 1993, The British journal of surgery.

[27]  K. Sikora,et al.  Tumour inoculation during laparoscopy , 1993, The Lancet.