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A comparison of laparoscopic and open D3 lymphadenectomy for transverse colon cancer

International Journal of Colorectal Disease volume 32, pages 1733–1739 (2017)Cite this article

Abstract

Purpose

The type of surgery or surgical approach for transverse colon cancer treatment largely depends on the tumor location or surgeon’s preference. However, extensive lymphadenectomy appears to improve the long-term outcomes of locally advanced colon cancers. This study was designed to compare the short- and long-term outcomes after surgery via the laparoscopic or open approach with radical D3 lymph node dissection in patients with stage II and III transverse colon cancer.

Methods

Patients were treated for stage II and III transverse colon cancer between May 2006 and December 2014. This retrospective study evaluated data collected prospectively at a tertiary teaching hospital. Radical D3 lymphadenectomy included the principal middle colic artery nodes.

Results

The study included 144 patients among whom 118 (81.9%) underwent laparoscopic surgery. Significantly more patients in the laparoscopic group underwent extended right hemicolectomy compared with the open group (90.7 vs. 65.4%, p = 0.005). The operative time was longer in the laparoscopic group (151.3 vs. 131.2 min, p = 0.021), and the open group had a greater estimated blood loss volume (160.8 vs. 289.3 ml, p = 0.011). Although the groups differed in terms of tumor size (5.8 vs 7.9 cm, p = 0.007), other pathologic outcomes did not differ. The groups did not differ regarding postoperative parameters or disease-free, overall, and cancer-specific survivals.

Conclusion

Despite differences in surgical methods and related factors, no long-term differences in outcomes were observed between laparoscopic and open approaches to radical D3 lymphadenectomy in patients with stage II and III transverse colon cancer.

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Affiliations

  1. Department of Surgery, Chonnam National University Hospital, 42 Jaebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Han Deok Kwak & Jae Kyun Ju

  2. Department of Surgery, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeonnam, 58128, Republic of Korea

    Soo Young Lee, Chang Hyun Kim, Young Jin Kim & Hyeong Rok Kim

Authors
  1. Han Deok Kwak
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  2. Jae Kyun Ju
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  3. Soo Young Lee
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  4. Chang Hyun Kim
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  5. Young Jin Kim
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  6. Hyeong Rok Kim
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Contributions

1. Study conception and design: Han Deok Kwak and Hyeong Rok Kim

Acquisition of data: Han Deok Kwak, Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Jae Kyun Ju, and Hyeong Rok Kim.

Analysis and interpretation of data: Han Deok Kwak, Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Jae Kyun Ju, and Hyeong Rok Kim.

2. Drafting the article or revising it critically for important intellectual content: Han Deok Kwak, Soo Young Lee, Chang Hyun Kim, Young Jin Kim, Jae Kyun Ju, and Hyeong Rok Kim.

3. Final approval of the version to be published: Jae Kyun Ju and Hyeong Rok Kim.

Corresponding authors

Correspondence to Jae Kyun Ju or Hyeong Rok Kim.

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Conflicts of interest

The authors declare that they have no conflicts of interest.

Additional information

Mini Abstract

The type or approaching method of surgery for transverse colon cancer treatment largely depends on the tumor location or surgeon’s preference because the surgical procedures have not yet been standardized. However, surgical resection of advanced colon cancers should be practiced in an oncologically verified manner. Therefore, this study was designed to compare the short- and long-term outcomes after surgery via the laparoscopic or open approach with radical D3 lymph node dissection, and despite of differences in surgical methods and related factors, no long-term differences in outcomes were observed between laparoscopic and open approaches in patients with stage II and III transverse colon cancer.

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Kwak, H.D., Ju, J.K., Lee, S.Y. et al. A comparison of laparoscopic and open D3 lymphadenectomy for transverse colon cancer. Int J Colorectal Dis 32, 1733–1739 (2017). https://doi.org/10.1007/s00384-017-2890-9

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  • DOI: https://doi.org/10.1007/s00384-017-2890-9

Keywords

  • Transverse colon cancer
  • Radical lymphadenectomy
  • Laparoscopy
  • Open
  • Outcomes