Long-term Outcomes After Laparoscopic Colectomy

Overview

Journal World J Gastrointest Oncol

Publisher Baishideng Publishing Group

Date 2011 Apr 5

PMID 21461168

Citations 13

Authors

Marco Braga

Nicolo Pecorelli

Matteo Frasson

Andrea Vignali

Walter Zuliani

Valerio Di Carlo

Affiliations

Soon will be listed here.

Abstract

Aim: To evaluate long-term outcomes in a large series of patients who randomly received laparoscopic or open colorectal resection.

Methods: From February 2000 to December 2004, six hundred sixty-two patients with colorectal disease were randomly assigned to laparoscopic (LPS, n = 330) or open (n = 332) colorectal resection. All patients were analyzed on an intention-to-treat basis. Long-term follow-up was carried out every 6 mo by office visits. In 526 cancer patients five-year overall and disease-free survival were evaluated. Median oncologic follow-up was 96 mo.

Results: Eight (4.2%) LPS group patients needed conversion to open surgery. Overall long-term morbidity rate was 7.6% (25/330) in the LPS vs 11.1% (37/332) in the open group (P = 0.17). In cancer patients, five-year overall survival was 68.6% in the LPS group and 64.0% in the Open group (P = 0.27). Excluding stage IV patients, five-year local and distant recurrence rates were 32.5% in the LPS group and 36.8% in the Open group (P = 0.36). Further, no difference in recurrence rate was found when patients were stratified according to cancer stage.

Conclusion: LPS colorectal resection was associated with a slightly lower incidence of long-term complications than open surgery. No difference between groups was found in overall and disease-free survival rates.

Citing Articles

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Shi B, Tai Q, Chen J, Shi X, Chen G, Yao H J Clin Med. 2023; 12(6).

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Propensity Score-Matched Analysis of Laparoscopic versus Open Surgery for Non-Metastatic Rectal Cancer.

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Clinicopathologic parameters associated with postoperative complications and risk factors for tumor recurrence and mortality after tumor resection of patients with colorectal cancer.

Bai Z, Wang J, Wang T, Li Y, Zhao X, Wu G Clin Transl Oncol. 2017; 20(2):176-192.

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Lymph node assessment in colorectal cancer surgery: laparoscopic versus open techniques.

Balducci G, Sederino M, Laforgia R, Carbotta G, Minafra M, Delvecchio A G Chir. 2017; 38(1):23-26.

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An evidence-based medicine approach to the laparoscopic treatment of colorectal cancer.

Otani T, Isohata N, Kumamoto K, Endo S, Utano K, Nemoto D Fukushima J Med Sci. 2016; 62(2):74-82.

PMID: 27477991 PMC: 5283946. DOI: 10.5387/fms.2016-4.

References

Taylor G, Jayne D, Brown S, Thorpe H, Brown J, Dewberry S . Adhesions and incisional hernias following laparoscopic versus open surgery for colorectal cancer in the CLASICC trial. Br J Surg. 2009; 97(1):70-8. DOI: 10.1002/bjs.6742. View

Braga M, Vignali A, Zuliani W, Radaelli G, Gianotti L, Toussoun G . Training period in laparoscopic colorectal surgery. Surg Endosc. 2002; 16(1):31-5. DOI: 10.1007/s00464-001-9035-4. View

Nduka C, Darzi A . Port-site metastasis in patients undergoing laparoscopy for gastrointestinal malignancy. Br J Surg. 1997; 84(4):583. DOI: 10.1002/bjs.1800840450. View

Nelson H, Sargent D, Wieand H, Fleshman J, Anvari M, Stryker S . A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004; 350(20):2050-9. DOI: 10.1056/NEJMoa032651. View

Balli J, Franklin M, Almeida J, Glass J, Diaz J, Reymond M . How to prevent port-site metastases in laparoscopic colorectal surgery. Surg Endosc. 2000; 14(11):1034-6. DOI: 10.1007/s004640000223. View

Buunen M, Veldkamp R, Hop W, Kuhry E, Jeekel J, Haglind E . Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2008; 10(1):44-52. DOI: 10.1016/S1470-2045(08)70310-3. View

Wichmann M, Huttl T, Winter H, Spelsberg F, Angele M, Heiss M . Immunological effects of laparoscopic vs open colorectal surgery: a prospective clinical study. Arch Surg. 2005; 140(7):692-7. DOI: 10.1001/archsurg.140.7.692. View

Braga M, Frasson M, Zuliani W, Vignali A, Pecorelli N, Di Carlo V . Randomized clinical trial of laparoscopic versus open left colonic resection. Br J Surg. 2010; 97(8):1180-6. DOI: 10.1002/bjs.7094. View

Wexner S, Cohen S . Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg. 1995; 82(3):295-8. DOI: 10.1002/bjs.1800820305. View

10.

Bergamaschi R, Pessaux P, Arnaud J . Comparison of conventional and laparoscopic ileocolic resection for Crohn's disease. Dis Colon Rectum. 2003; 46(8):1129-33. DOI: 10.1007/s10350-004-7292-8. View

11.

Berends F, Kazemier G, Bonjer H, Lange J . Subcutaneous metastases after laparoscopic colectomy. Lancet. 1994; 344(8914):58. DOI: 10.1016/s0140-6736(94)91079-0. View

12.

Leung K, Kwok S, Lam S, Lee J, Yiu R, Ng S . Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet. 2004; 363(9416):1187-92. DOI: 10.1016/S0140-6736(04)15947-3. View

13.

Takeuchi I, Ishida H, Mori T, Hashimoto D . Comparison of the effects of gasless procedure, CO2-pneumoperitoneum, and laparotomy on splenic and hepatic natural killer activity in a rat model. Surg Endosc. 2003; 18(2):255-60. DOI: 10.1007/s00464-002-9180-4. View

14.

Lacy A, Garcia-Valdecasas J, Delgado S, Castells A, Taura P, Pique J . Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002; 359(9325):2224-9. DOI: 10.1016/S0140-6736(02)09290-5. View

15.

Jackson T, Kaplan G, Arena G, Page J, Rogers Jr S . Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg. 2007; 204(3):439-46. DOI: 10.1016/j.jamcollsurg.2006.12.008. View

16.

Brundell S, Tucker K, Texler M, Brown B, Chatterton B, Hewett P . Variables in the spread of tumor cells to trocars and port sites during operative laparoscopy. Surg Endosc. 2002; 16(10):1413-9. DOI: 10.1007/s00464-001-9112-8. View

17.

Lacy A, Delgado S, Castells A, Prins H, Arroyo V, Ibarzabal A . The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg. 2008; 248(1):1-7. DOI: 10.1097/SLA.0b013e31816a9d65. View

18.

Braga M, Vignali A, Gianotti L, Zuliani W, Radaelli G, Gruarin P . Laparoscopic versus open colorectal surgery: a randomized trial on short-term outcome. Ann Surg. 2002; 236(6):759-66; disscussion 767. PMC: 1422642. DOI: 10.1097/01.SLA.0000036269.60340.AE. View

19.

Fleshman J, Sargent D, Green E, Anvari M, Stryker S, Beart Jr R . Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial. Ann Surg. 2007; 246(4):655-62. DOI: 10.1097/SLA.0b013e318155a762. View

20.

Duepree H, Senagore A, Delaney C, Fazio V . Does means of access affect the incidence of small bowel obstruction and ventral hernia after bowel resection? Laparoscopy versus laparotomy. J Am Coll Surg. 2003; 197(2):177-81. DOI: 10.1016/S1072-7515(03)00232-1. View