Skip to main content

Short-term outcomes following laparoscopic resection for colon cancer

Abstract

Background

Laparoscopic resection for colon cancer has been proven to have a similar oncological efficacy compared to open resection. Despite this, it is performed by a minority of colorectal surgeons. The aim of our study was to evaluate the short-term clinical, oncological and survival outcomes in all patients undergoing laparoscopic resection for colon cancer.

Methods

From July 2005 to December 2008, 202 consecutive patients underwent laparoscopic resection for colon cancer. Surgery was analysed on an intention to treat basis. The mean follow-up was 24.3 months.

Results

Two hundred twenty-two patients underwent resection for colon cancer. Two hundred two underwent laparoscopic resection (91%). One hundred sixteen were male patients. Mean age was 65.9 years (range = 24–91). The median length of stay was 6.6 days (mean = 7.1 days). One hundred eighty-eight of 202 (93.1%) were completed laparoscopically. Fourteen (6.9%) were converted. The overall morbidity rate was 15.8%. There were three clinically apparent anastomotic leaks. The 30-day mortality was 1 (0.5%). The mean nodal yield was 13.4 (range = 8–37) nodes. There were no positive margins detected. Overall survival in laparoscopically treated colon cancer was 88.1%. In those patients with non-metastatic disease, the overall survival was 90.7% (165/182).

Conclusion

Laparoscopic resection for colon cancer is achievable in 85% (188/222) of patients. This facilitates adequate oncological clearance. It is associated with a low morbidity rate and favourable short-term survival outcomes. This data reflects the potential outcomes dedicated MIS colorectal units will have to offer colon cancer patients once laparoscopic colorectal surgery becomes the de facto surgical approach.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ (2003) Cancer statistics. CA Cancer J Clin 53:5–26

    Article  PubMed  Google Scholar 

  2. Steele RJC (2005) Colorectal Surg 3:41–67, Elsevier

    Google Scholar 

  3. Schwenk W, Böhm B, Müller JM (1998) Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. a prospective randomized trial. Surg Endosc 12:1131–1136

    CAS  Article  PubMed  Google Scholar 

  4. Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150

    CAS  PubMed  Google Scholar 

  5. Stocchi L, Nelson H (1998) Laparoscopic colectomy for colon cancer: trial update. J Surg Oncol 68:255–267

    CAS  Article  PubMed  Google Scholar 

  6. Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Pique TP, JM VJ (2002) Laparoscopic-assisted colectomy versus open colectomy for the treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229

    Article  PubMed  Google Scholar 

  7. Lacy AM, Delgado S, Castells A, Prins HA, Arroyo V, Ibarzabal A, Pique JM (2008) The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg 248(1):1–7

    Article  PubMed  Google Scholar 

  8. Nelson H, Sargent DJ, Wienand HS, Fleshman J, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan RW, Ota D (2004) The clinical outcomes of surgical therapy study group. a comparison of laparoscopically assisted and open colectomy for colon cancer. New Engl J Med 350:2050–2059

    CAS  Article  Google Scholar 

  9. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H (2007) For the clinical outcomes of surgical therapy study group. laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg 246(4):655–662, discussion 662-4

    Article  PubMed  Google Scholar 

  10. Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM (2005) Short-term endpoints of conventional vs. laparoscopic-assisted surgery in patients with colorectal cancer MRC-CLASICC trial: multicenter randomized controlled trial. Lancet 365:1718–1726

    Article  PubMed  Google Scholar 

  11. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AMH, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol 25:3061–3068

    Article  PubMed  Google Scholar 

  12. Delaney C, Neary P, Heriot A (2006) Operative techniques in laparoscopic colorectal surgery. Lippincott Williams & Wilkins, USA

    Google Scholar 

  13. Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left sided resections. Ann Surg 242:83–91

    Article  PubMed  Google Scholar 

  14. Colon cancer Laparoscopic or Open Resection Study Group (COLOR) (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcomes of a randomized trial. Lancet Oncol 10:44–53

    Article  Google Scholar 

  15. Lengyel J, Morrison C, Sagar PM (2010) Trends toward increased use of the laparoscopic approach in colorectal surgery. Colorectal Dis 12(10):1007–1012

    CAS  Article  PubMed  Google Scholar 

  16. Baker RP, Titu LV, Hartley JE, Lee PW, Monson JR (2004) A case–control study of laparoscopic right hemicolectomy vs. open right hemicolectomy. Dis Colon Rectum 47(10):1675–1679

    Article  PubMed  Google Scholar 

  17. Scala A, Huang A, Dowson HM, Rockall TA (2007) Laparoscopic colorectal surgery—results from 200 patients. Colorectal Dis 9(8):701–705

    CAS  Article  PubMed  Google Scholar 

  18. Raymond T, Kumar S, Dastur J, Adamek J, Khot U, Stewart M, Parker M (2010) Case controlled study of the hospital stay and return to full activity following laparoscopic and open colorectal surgery before and after the introduction of an enhanced recovery programme. Colorectal Dis 12(10):1001–1006

    CAS  Article  PubMed  Google Scholar 

  19. Lordan JT, Tilney HS, Shirol S, Jourdan I, Gudgeon AM (2008) Does the laparoscopic colorectal surgery learning curve adversely affect the results of colorectal cancer resection? A 3-year prospective study in a district general hospital. Colorectal Dis 10(4):363–369

    CAS  Article  PubMed  Google Scholar 

  20. Mirza MS, Longman RJ, Farrokhyar F, Sheffield JP, Kennedy RH (2008) Long-term outcomes for laparoscopic versus open resection of nonmetastatic colorectal cancer. J Laparoendosc Adv Surg Tech A 18(5):679–685

    Article  PubMed  Google Scholar 

  21. Mehigan B, White A, Winter DC, Sheehan KM, Hyland JM (2006) Laparoscopic colorectal resection: initial experience in a specialized unit. Ir Med J 99(7):211–214

    CAS  PubMed  Google Scholar 

  22. Buchanan GN, Malik A, Parvaiz A, Sheffield JP, Kennedy RH (2008) Laparoscopic resection for colorectal cancer. Br J Surg 95:893–902

    CAS  Article  PubMed  Google Scholar 

  23. Neary PC, Boyle E, Delaney CP, Senagore AJ, Keane FB, Gallagher AG (2008) Construct validation of a novel hybrid virtual-reality simulator for training and assessing laparoscopic colectomy; results from the first course for experienced senior laparoscopic surgeons. Surg Endosc 22(10):2301–2309

    Article  PubMed  Google Scholar 

  24. ACPGBI. Guidelines for the Management of Colorectal Cancer, 3rd edn. The Association of Coloproctologists of Great Britain and Northern Ireland, London

  25. Boyle E, Ridgway PF, Keane FB, Neary P (2008) Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay. Colorectal Dis 10(9):911–915

    CAS  Article  PubMed  Google Scholar 

  26. Phitayakorn R, Delaney CP, Reynolds HL, Champagne BJ, Heriot AG, Neary P, Senagore AJ, International Anastomotic Leak Study Group (2008) Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery. World J Surg 32(6):1147–1156

    CAS  Article  PubMed  Google Scholar 

  27. Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer HJ (2008). Long-term results of laparoscopic colorectal cancer resection. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD003432. doi: 10.1002/14651858.CD003432.pub2

  28. Young-Fadok TM (2007) Colon cancer: trials, results, techniques (Lap and HALS), future. J Surg Oncol 96:651–659

    Article  PubMed  Google Scholar 

  29. Liang JT, Huang KC, Lai HS, Lee PH, Jeng YM (2006) Oncologic results of laparoscopic versus conventional open surgery for stage II or III left-sided colon cancers: a randomized controlled trial. Ann Surg Oncol 14(1):109–117

    Article  PubMed  Google Scholar 

  30. Braga M, Frasson M, Vignali A, Zuliani W, Civelli V, Di Carlo V (2005) Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life and survival. Dis Col Rect 48:2217–2223

    Article  Google Scholar 

  31. Naitoh T, Tsuchiya T, Honda H, Oikawa M, Saito Y, Hasegawa Y (2008) Clinical outcome of laparoscopic surgery for stage II and III colorectal cancer. Surg Endosc 22:950–954

    Article  PubMed  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Dara O. Kavanagh.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kavanagh, D.O., Gibson, D., Moran, D.C. et al. Short-term outcomes following laparoscopic resection for colon cancer. Int J Colorectal Dis 26, 361–368 (2011). https://doi.org/10.1007/s00384-010-1069-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-010-1069-4

Keywords

  • Laparoscopy
  • Port site metastases
  • Survival in colon cancer
  • Survival following laparoscopic colon resection