Abstract
Laparoscopic colon resection (LCR) has been performed in the United States sine 1990. This procedure has been accepted by many as a reasonable alternative for nonmalignant, colonic, surgical disease, but the laparoscopic approach remains controversial for curative treatment of carcinoma. In this paper, the results of a nonrandomized series of two large experiences of laparoscopic colon resections were performed and followed for 3 1/2 years in a prospective fashion against an equal number of patients who underwent open resection. The setting was several large metropolitan hospitals in San Antonio, Texas. Over 194 patients were involved in this study. Each patient once diagnosed with resectable colonic cancer was allowed to choose their own procedure, laparoscopic or open colon resection, either of which was performed by the authors. Factors considered include age, sex, body habitus, stage of cancer, margins of resection, numbers of lymph nodes retrieved, hospitalization time, and follow-up period. Observations at this time indicate the following: (1) LCR allows for resection comparable to the classical approach, (2) equal numbers of mesenteric lymph nodes can be retrieved, (3) adequacy of margins of resection can be accurately determined by colonoscopy during LCR, and (4) brief follow-up periods show comparable survival and disease-free intervals. It is the conclusion of the authors that with proper training LCR will come to be recognized as a safe, effective surgical option for treatment of selected patients with colon cancer.
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References
American Cancer Society (1989) Cancer statistics. CA Vol. 39
Astler VV, Coller FA (1954) The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg 139: 846–851
Cameron JL (ed) Current surgical therapy, 4th ed. Mosby Year Book, St Louis, MO, pp. 191–202
Cooperman A, Zucker KA (1991) Laparoscopic guided intestinal surgery. In: Zucker KA, Bailey RW, Reddick EJ (eds) Surgical laparoscopy. Quality Medical Publications, St Louis, pp 295–310
Fowler DL, White SA (1991) Laparoscopy-assisted sigmoid resection. Surg Laparosc Endosc 1: 183–188
Franklin ME, Ramos R, Rosenthal D, Schussler W (1993) Laparoscopic colonic procedures. World J Surg 17: 51–56
Franklin ME, Rosenthal D, Ramos R (1993) Laparoscopy colectomy: utopia or reality? Gastrointest Clin North Am 3: 353–365
Jacobs M, Verdeja GD, Goldstein DS (1992) Minimally invasive colon resection. Surg Lap Endosc 2: 144–150
Lincaweaver W (1984) Staging colon cancer. Contemp Surg 25: 19–24
Phillips EH, Franklin ME, Carroll BJ, Fallas MJ, Ramos R, Rosenthal D. (1992) Laparoscopic colectomy. Ann Surg 216: 703–707
Quirke P, Durdey P, Dixon MF, Williams NS (1986) Local recurrence of rectal adenocarcinoma due to inadequate surgical resection. Lancet 8514: 996–999
Redwine DB, Sharpe DR (1991) Laparoscopic segmental resection of the sigmoid colon for endometriosis. J Laparoendosc Surg 1: 217–220
SAGES meeting presentation (1993) Nashville, TN May
Schwartz EI, Ellis H (eds) Mangot's abdominal operations, 9th ed. Appleton and Lange, Norwalk, CN, pp 1040–1076
Schwartz SI (ed) Principles of surgery, 5th ed McGraw-Hill, New York, pp 1270–1287
Silverberg E, Lubera JA (1983) A review of American Cancer Society estimates of cancer cases and deaths. CA Vol. 33
Sugarbaker PH, Corlew S (1982) Influence of surgical techniques on survival in patients with colon cancer: a review. Dis Col Rectum 25: 545–557
Turnbull RB, Kyle K, Watson FR, Spratt J (1967) Cancer: the influence of the no-touch isolation technique on survival rates. Ann Surg 166: 420–425
Williams NS, Dixon MF, Johnson D (1983) Reappraisal of the centimetre rule of excision for carcinoma of the rectum: a study of distal intramural spead and of patients' survival. Br J Surg 70: 150–154
Zinkin LD (1983) A critical review of the classifications and staging of colorectal cancer. Dis Col Rectum 26: 37–43
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Franlin, M.E., Rosenthal, D. & Norem, R.F. Prospective evaluation of laparoscopic colon resection versus open colon resection for adenocarcinoma. Surg Endosc 9, 811–816 (1995). https://doi.org/10.1007/BF00190088
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DOI: https://doi.org/10.1007/BF00190088