Abstract
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.
Similar content being viewed by others
References
Alexander RJT, Jaques BC, Mitchell KG (1993) Laparoscopically assisted colectomy and wond recurrence (letter). Lancet 341: 249–250
Astler V, Coller F (1954) The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg 139: 846–851
Beart R (1994) Laparoscopic colectomy: status of the art. Dis Colon Rectum 37 (Suppl): S47-S49
Berends FJ, Kazemier G, Bonjer HJ, Lange JF (1994) Subcutaneous metastases after laparoscopic colectomy (letter). Lancet 344: 58
Cohen S, Wexner S (1993) Laparoscopic colorectal resection for cancer: the Cleveland Clinic Florida experience. Surg Oncol 2 (Suppl): 35–42
Coller JA (1991) Laparoscopic assisted right hemi-colectomy. Dis Colon Rectum 34: 1030–1031
Cushieri A, Dubois F, Mouil JEA (1991) The European experience with laparoscopic cholecystectomy. Am J Surg 161: 385–387
Dubois F, Berthelot G, Levard H (1989) Cholecystectomy par celioscopies. Presse Med 18: 980–982
Dubois F, Icard P, Berthelholt G, Levard H (1990) Coelioscopic cholecystectomy. Ann Surg 211: 60–62
Falk PM, Beart RW, Wexner SD, Thorson AG, Jagelamn DG, Lavery IC, Johansen OB, Fitzgibbons RJ (1993) Laparoscopic colectomy: a critical appraisal. Dis Colon Rectum 36(1): 28–34
Fusco MA, Paluzzi MW (1993) Abdominal wall recurrence after laparoscopic assisted colectomy for adenocarcinoma of the colon. Dis Colon Rectum 36: 858–861
Guillou P, Darzi A, Monson J (1993) Experience with laparoscopic colorectal surgery for malignant disease. Surg Oncol 2 (Suppl): 43–49
Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection. Surg Laparosc Endosc 1: 138–143
Lacy AM, García-Valdecasas JC, Taurá P, Piqué JM, Bordas JM, Campo E, Grande L, Fuster J, Andrade E, Cugat E, Gonzalez FX, Delgado S, Visa J, (1995) Estudio comparativo con cirugía convencional y cirugía asistida por laparoscopia en el cancer de colon. Cirugía Espanñola 57(3): 238–239
Lacy AM, García-Valdecasas JC, Taurá P, Bordas, JM, Grande L, Fuster J, Cugat E, Visa J (1994) Is laparoscopic colectomy a safe procedure in synchronous colorectal carcinoma? Report of a case. Surg Laparosc Endosc (in press)
Monson JR, Darzi A, Carey PD, Guillou PJ (1992) Prospective evaluation of laparoscopic assisted colectomy in an unselected group of patients. Lancet 340: 831–833
O'Rourke N, Price P, Kelly S, Sikora K (1993) Tumor inoculation during laparoscopy. Lancet 342: 368
O'Rourke NA, Heald RJ (1993) Laparoscopic surgery for colorectal cancer. Br J Surg 80: 1229–1230
Ramos J, Gupta S, Anthone G, Ortega A, Simons A, Beart R (1994) Laparoscopy and colon cancer. Is the port site at risk? A preliminary report. Arch Surg 129: 897–900
Reddick EJ, Olsen DO (1989) Laparoscopic laser cholecystectomy. A comparison with mini-lap cholecystectomy. Surg Endosc 3(3): 131–133
Scott K, Grace R (1989) Detection of lymph node metastases in colorectal carcinoma before and after fat clearance. Br J Surg 76: 1165–1167
Snedecor GW, Cochran WG (eds) (1967) Statistical methods, 6th ed. Iowa State University Press, Ames, IA
Van Ye T, Cattey R, Henry L (1994) Laparoscopically assisted colon resections compare favorably with open technique. Surg Laparosc Endosc 4(1): 25–31
Walsh D, Wattchow D, Wilson T (1993) Subcutaneous metastases after laparoscopic resection of malignancy. Aust N Z J Surg 63: 563–565
Wexner SD, Cohen SM, Johansen OB, Nogueras JJ, Jagelman DG (1993) Laparoscopic colorectal surgery: a prospective assessment and current perspective. Br J Surg 80: 1602–1605
Wexner SD, Johansen OB, Nogueras JJ, Jagelman DG (1992) Laparoscopic total abdominal colectomy. A prospective trial. Dis Colon Rectum 35(7): 651–655
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Lacy, A.M., García-Valdecasas, J.C., Piqué, J.M. et al. Short-term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer. Surg Endosc 9, 1101–1105 (1995). https://doi.org/10.1007/BF00188996
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00188996