Annals of Surgical Oncology

, Volume 18, Issue 5, pp 1412–1418

Minimally Invasive Surgery Is Underutilized for Colon Cancer

  • Celia N. Robinson
  • G. John Chen
  • Courtney J. Balentine
  • Shubhada Sansgiry
  • Christy L. Marshall
  • Daniel A. Anaya
  • Avo Artinyan
  • Daniel Albo
  • David H. Berger
Colorectal Cancer

DOI: 10.1245/s10434-010-1479-0

Cite this article as:
Robinson, C.N., Chen, G.J., Balentine, C.J. et al. Ann Surg Oncol (2011) 18: 1412. doi:10.1245/s10434-010-1479-0

Abstract

Background

The Clinical Outcomes of Surgical Therapy Group (COST) trial published in 2004 demonstrated that minimally invasive surgery (MIS) for colorectal cancer provided equivalent oncologic results and better short-term outcomes when compared to open surgery. Before this, MIS comprised approximately 3% of colorectal cancer cases. We hypothesized that there would be a dramatic increase in the use of MIS for colon cancer after this publication.

Methods

The National Inpatient Sample database was used to retrospectively review MIS and open colon resections from 2005 through 2007. ICD-9-specific procedure codes were used to identify open and MIS colon cancer resections. Statistical analyses performed included Pearson χ2 tests and dependent t tests, and Cramer’s V was used to measure the strength of association.

Results

A total of 240,446 colon resections were performed between 2005 and 2007. The percentage of resections performed laparoscopically increased from 4.7% in 2005 to 6.7% in 2007 for colon cancer and remained relatively unchanged for benign disease (25.2% in 2005 vs. 27.4% in 2007, P < 0.007). Patients undergoing laparoscopic colectomy were younger, had lower comorbidity scores, had lower rates of complications (20.1 vs. 25.1%, P < 0.001), had shorter lengths of stay (7.2 vs. 9.6 days, P < 0.001), and had lower mortality (1.5 vs. 3.0%, P < 0.001). Furthermore, when evaluating adoption trends, urban teaching hospitals adopted laparoscopy more rapidly than rural nonteaching centers.

Conclusions

Adoption of MIS for the treatment of colorectal cancer has been slow. Additional studies to evaluate barriers in the adoption of MIS for colon cancer resection are warranted.

Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Celia N. Robinson
    • 1
    • 2
  • G. John Chen
    • 3
  • Courtney J. Balentine
    • 1
    • 2
    • 3
  • Shubhada Sansgiry
    • 3
  • Christy L. Marshall
    • 1
    • 2
  • Daniel A. Anaya
    • 1
    • 2
    • 3
  • Avo Artinyan
    • 1
    • 2
  • Daniel Albo
    • 1
    • 2
  • David H. Berger
    • 1
    • 2
    • 3
  1. 1.Operative Care LineThe Michael E. DeBakey Veterans Affairs Medical CenterHoustonUSA
  2. 2.Division of Surgical Oncology, Michael E. DeBakey Department of SurgeryBaylor College of MedicineHoustonUSA
  3. 3.Houston VA Health Services Research and Development Center of ExcellenceMichael E. DeBakey VA Medical CenterHoustonUSA

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