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Outcomes of laparoscopic surgery in pathologic T4 colon cancers compared to those of open surgery

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Introduction

Despite the oncologic safety of laparoscopic surgery in colon cancer management, laparoscopy is not regarded as a standard treatment for T4 colon cancer. The aim of this study was to investigate the short-term and long-term oncologic outcomes of laparoscopic surgery in patients with locally advanced colon cancer.

Material and method

From March 2003 to June 2013, a total of 109 consecutive patients with proven pathologic T4 colon cancer were enrolled. These patients were divided into the laparoscopy group (LG, n = 52) and the open group (OG, n = 57). Perioperative and long-term oncologic outcomes were compared between the two groups.

Results

In the LG, open conversion occurred in four patients (7.6%). Combined resection was less commonly performed in the LG (13.5%) than in the OG (36.8%, P = 0.005). Operation time was similar between the two groups. In the LG, blood loss (129 mL vs. 437 mL, P < 0.001) and overall complication rate (13.5 vs. 36.8%, P = 0.005) were lower and length of hospital stay was shorter (median 7 vs. 17 days, P < 0.001) than in the OG. The 5-year overall survival rate was 60.7% for the LG and 61.9% for the OG (P = 0.817). Local recurrence-free survival did not differ between the groups (88.9% in LG vs. 88.1% in OG, P = 0.725).

Conclusion

Considering the benefits of early recovery and similar oncologic outcomes, laparoscopic surgery in T4 colon cancer could be a viable option in selected patients.

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Acknowledgments

The authors are grateful to Dong-Su Jang, (Medical Illustrator, Medical Research Supporting Section, Yonsei University College of Medicine, Seoul, Korea) for his help with the figures.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul, 06273, South Korea

    Jeonghyun Kang, Seung Hyuk Baik, Kang Young Lee & Seung-Kook Sohn

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  1. Jeonghyun Kang
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  2. Seung Hyuk Baik
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Correspondence to Jeonghyun Kang.

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Kang, J., Baik, S.H., Lee, K.Y. et al. Outcomes of laparoscopic surgery in pathologic T4 colon cancers compared to those of open surgery. Int J Colorectal Dis 32, 531–538 (2017). https://doi.org/10.1007/s00384-016-2720-5

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