Abstract
Background
No previous report could be found in the literature comparing laparoscopic and open total colectomy for colorectal cancers, especially synchronous colorectal cancers. This study aimed to compare the short-term clinical outcomes and oncologic results of laparoscopic and open total colectomy or proctocolectomy for colorectal cancers.
Methods
Between July 1997 and January 2005, six patients with colorectal cancers underwent elective laparoscopic total colectomy or proctocolectomy at the authors’ institution. Clinical data for 12 patients who underwent elective open total colectomy or proctocolectomy for colorectal cancers during the same period were prospectively collected and compared.
Results
The median follow-up periods were 43.9 months for the laparoscopic group and 48.2 months for the open group. Conversion to open procedure was required for one patient (16.7%) in the laparoscopic group because of bleeding. The median operative time was significantly longer in the laparoscopic group (427.5 min; range, 280–480 min vs 172.5 min; range, 90–260 min; p = 0.001). The patients in the laparoscopic group required a significantly shorter duration of parenteral analgesia (3 vs 5 days; p = 0.01), but there were no differences in time to first bowel motion, time to resumption of diet, time to full ambulation, and duration of hospital stay between the two groups. Perioperative morbidity rates were comparable between the two groups, and there was no operative mortality. The oncologic results, including number of lymph nodes removed, recurrence rates, and survival rates, were similar in the two groups.
Conclusions
Laparoscopic total colectomy has short-term clinical outcomes (postoperative recovery and perioperative morbidity and mortality rates) and oncologic results similar to those of open surgery for treating patients with colorectal cancers. Our study has shown that the only advantage of laparoscopic over open surgery is a shorter duration of analgesic requirement, but at the expense of a longer operative time.
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References
Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91: 1111–1124
Araki Y, Isomoto H, Matsumoto A, Yasunaga M, Toh U, Yamauchi K, Shirouzu K (1998) Clinical aspects of total colectomy: laparoscopic versus open technique for familial adenomatous polyposis and ulcerative colitis. Kurume Med J 45: 203–207
Balli JE, Franklin ME, Almeida JA, Glass JL, Diaz JA, Reymond M (2000) How to prevent port-site metastases in laparoscopic colorectal surgery. Surg Endosc 14: 1034–1036
Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350: 2050–2059
Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of nonmetastatic colon cancer: a randomised trial. Lancet 359: 2224–2229
Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363: 1187–192
Lointier PH, Lautard M, Massoni C, Ferrier C, Dapoigny M (1993) Laparoscopically assisted subtotal colectomy. J Laparoendosc Surg 3: 439–453
Milsom JW, Ludwig KA, Church JM, Garcia-Ruiz A (1997) Laparoscopic total abdominal colectomy with ileorectal anastomosis for familial adenomatous polyposis. Dis Colon Rectum 40: 675–678
Pokala N, Delaney CP, Senagore AJ, Brady KM, Fazio VW (2005) Laparoscopic vs open total colectomy: a case-matched comparative study. Surg Endosc 19: 531–535
Seshadri PA, Poulin EC, Schlachta CM, Cadeddu MO, Mamazza J (2001) Does a laparoscopic approach to total abdominal colectomy and proctocolectomy offer advantages? Surg Endosc 15: 837–842
Veldkamp R, Gholghesaei M, Bonjer HJ, Meijer DW, Buunen M, Jeekel J, Anderberg B, Cuesta MA, Cuschieri A, Fingerhut A, Fleshman JW, Guillou PJ, Haglind E, Himpens J, Jacobi CA, Jakimowicz JJ, Koeckerling F, Lacy AM, Lezoche E, Monson JR, Morino M, Neugebauer E, Wexner SD, Whelan RL, European Association of Endoscopic Surgery (EAES) (2004) Laparoscopic resection of colon cancer: consensus of the European Association of Endoscopic Surgery (EAES). Surg Endosc 18: 1163–1185
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Ng, S.S.M., Li, J.C.M., Lee, J.F.Y. et al. Laparoscopic total colectomy for colorectal cancers: a comparative study. Surg Endosc 20, 1193–1196 (2006). https://doi.org/10.1007/s00464-005-0330-3
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DOI: https://doi.org/10.1007/s00464-005-0330-3