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Does a laparoscopic approach affect the number of lymph nodes harvested during curative surgery for colorectal cancer?

Surgical Endoscopy volume 24, pages 113–118 (2010)Cite this article

Abstract

Background

This study aimed to assess the number of lymph nodes (LNs) harvested after laparoscopic and open colorectal cancer resections.

Methods

Between 1996 and 2007, 431 colorectal cancer patients underwent laparoscopic resection. During the periods of 1996–1997, 2002–2003, and 2006–2007, 243 patients undergoing laparoscopic colorectal cancer resection were matched 1–2 by age, operation, gender, operation date, body mass index (BMI), and tumor stage (TNM) to 486 patients undergoing open surgery. The numbers of examined and involved LNs were compared according to tumor location and year of surgery.

Results

Colorectal cancer resections (243 laparoscopic and 486 open procedures) were performed for 729 patients (447 men) with a mean age of 66.2 ± 12.3 years and a mean BMI of 28.5 ± 7.3. The mean number of LNs per case was 24.8 ± 20.6. The number of LNs retrieved did not differ between laparoscopic and open surgery (p = 0.4). A significant difference was observed between the number of involved LNs retrieved laparoscopically (2.2 ± 3.8) and the number retrieved by open surgery (1.6 ± 4; p = 0.03). There were significant differences between the numbers of LNs retrieved from the right colon (28.1 ± 14.6), left colon (24.5 ± 17.6), and rectum (19.1 ± 15.1) (p < 0.001). There were significantly fewer examined LNs in laparoscopic than in open cases during 2002 and 2003 (p = 0.003).

Conclusion

Laparoscopic resection of colorectal cancer can achieve lymph node retrieval similar to that achieved by the open approach. In this era of new technology, laparoscopic lymph node harvest is becoming more optimized.

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Affiliations

  1. A30 Department of Colorectal Surgery, Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Galal El-Gazzaz, Tracy Hull, Jeffery Hammel & Daniel Geisler

Authors
  1. Galal El-Gazzaz
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  2. Tracy Hull
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  3. Jeffery Hammel
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  4. Daniel Geisler
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Correspondence to Daniel Geisler.

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El-Gazzaz, G., Hull, T., Hammel, J. et al. Does a laparoscopic approach affect the number of lymph nodes harvested during curative surgery for colorectal cancer?. Surg Endosc 24, 113–118 (2010). https://doi.org/10.1007/s00464-009-0534-z

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  • DOI: https://doi.org/10.1007/s00464-009-0534-z

Keywords

  • Colorectal cancer
  • Laparoscopic resection
  • Number of lymph nodes
  • Open resection