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Laparoscopic vs. Open Colectomy in Cancer Patients: Long-Term Complications, Quality of Life, and Survival

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Diseases of the Colon & Rectum


This study was designed to evaluate long-term complications, quality of life, and survival rate in a series of colorectal cancer patients randomized to laparoscopic or open surgery.


A total of 391 patients with colorectal cancer were randomly assigned to laparoscopic (n = 190) or open (n = 201) resection. Long-term follow-up was performed every six months by office visits. Quality of life was assessed at 12, 24, and 48 months after surgery by a modified version of Short Form 36 Health Survey questionnaire. All patients were analyzed on an intention-to-treat basis.


Eight (4.2 percent) laparoscopic group patients needed conversion to open surgery. Overall long-term morbidity rate was 6.8 percent (13/190) in the laparoscopic vs. 14.9 percent (30/201) in the open group (P = 0.018). Overall quality of life was significantly better in the laparoscopic group in the first 12 months after surgery, whereas at 24 months, patients of the laparoscopic group reported a significant advantage only in social functioning. No difference was found in both overall and disease-free survival rates by comparing laparoscopic vs. open group.


Laparoscopic colorectal resection was associated with a lower incidence of long-term complications and a better quality of life in the first 12 months after surgery compared with open surgery. No difference between groups was found in overall and disease-free survival rates.

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  1. M Braga A Vignali L Gianotti et al. (2002) ArticleTitleLaparoscopic versus open colorectal surgery. A randomized trial on short-term outcome Ann Surg 236 759–67 Occurrence Handle12454514 Occurrence Handle10.1097/00000658-200212000-00008

    Article  PubMed  Google Scholar 

  2. AM Lacy JC Garcia-Valdecasas S Delgado et al. (2002) ArticleTitleLaparoscopy–assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial Lancet 359 2224–9 Occurrence Handle12103285 Occurrence Handle10.1016/S0140-6736(02)09290-5

    Article  PubMed  Google Scholar 

  3. KL Leung SP Kwok SC Lam et al. (2004) ArticleTitleLaparoscopic resection of rectosigmoid carcinoma: prospective randomised trial Lancet 363 1187–92 Occurrence Handle15081650 Occurrence Handle10.1016/S0140-6736(04)15947-3

    Article  PubMed  Google Scholar 

  4. H Nelson DJ Sargent HS Wieand et al. (2004) ArticleTitleA comparison of laparoscopically assisted and open colectomy for colon cancer N Engl J Med 350 2050–9 Occurrence Handle10.1056/NEJMoa032651 Occurrence Handle1:CAS:528:DC%2BD2cXktVemsbw%3D

    Article  CAS  Google Scholar 

  5. J Psaila SH Bulley P Ewings JP Sheffield RH Kennedy (1998) ArticleTitleOutcome following laparoscopic resection for colorectal cancer Br J Surg 85 662–4 Occurrence Handle9635817 Occurrence Handle10.1046/j.1365-2168.1998.00634.x Occurrence Handle1:STN:280:DyaK1c3pslOnsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  6. JC Weeks H Nelson S Gelber D Sargent G Schroeder (2002) ArticleTitleShort-term quality of life outcomes following laparoscopic-assisted colectomy vs. open colectomy for colon cancer: a randomized trial JAMA 16 321–8 Occurrence Handle10.1001/jama.287.3.321

    Article  Google Scholar 

  7. K Thaler A Dinnewitzer E Mascha et al. (2003) ArticleTitleLong-term outcome and health-related quality of life after laparoscopic and open colectomy for benign disease Surg Endosc 17 1404–8 Occurrence Handle12802642 Occurrence Handle10.1007/s00464-002-8855-1 Occurrence Handle1:STN:280:DC%2BD2c7ks1Ogsw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  8. M Braga A Vignali W Zuliani et al. (2002) ArticleTitleTraining period in laparoscopic colorectal surgery. A case-matched comparative study with open surgery Surg Endosc 16 31–5 Occurrence Handle11961600 Occurrence Handle10.1007/s00464-001-9035-4 Occurrence Handle1:STN:280:DC%2BD383isFGnsQ%3D%3D

    Article  PubMed  CAS  Google Scholar 

  9. F Bozzetti M Braga L Gianotti C Gavazzi L Mariani (2001) ArticleTitlePostoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trial Lancet 358 1487–92 Occurrence Handle11705560 Occurrence Handle10.1016/S0140-6736(01)06578-3 Occurrence Handle1:STN:280:DC%2BD3MnltFKqsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  10. JE Ware SuffixJr CD Sherbourne (1992) ArticleTitleThe MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection Med Care 30 473–83 Occurrence Handle1593914 Occurrence Handle10.1097/00005650-199206000-00002

    Article  PubMed  Google Scholar 

  11. P Rauch J Miny T Conroy L Neyton F Guillemin (2004) ArticleTitleQuality of life among disease-free survivors of rectal cancer J Clin Oncol 22 354–60 Occurrence Handle14722043 Occurrence Handle10.1200/JCO.2004.03.137

    Article  PubMed  Google Scholar 

  12. V Arndt H Merx C Stegmaier H Ziegler H Brenner (2004) ArticleTitleQuality of life in patients with colorectal cancer 1 year after diagnosis compared with general population: a population-based study J Clin Oncol 22 4829–36 Occurrence Handle15570086 Occurrence Handle10.1200/JCO.2004.02.018

    Article  PubMed  Google Scholar 

  13. I Kopp A Bauhofer M Koller (2004) ArticleTitleUnderstanding quality of life in patients with colorectal cancer: comparison of data from a randomised controlled trial, a population based cohort study and the norm reference population Inflamm Res 53 S130–5 Occurrence Handle15338064 Occurrence Handle10.1007/s00011-004-0361-6 Occurrence Handle1:CAS:528:DC%2BD2cXns1yiu74%3D

    Article  PubMed  CAS  Google Scholar 

  14. NS Abraham JM Young MJ Solomon (2004) ArticleTitleMeta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer Br J Surg 91 1111–24 Occurrence Handle15449261 Occurrence Handle10.1002/bjs.4640 Occurrence Handle1:STN:280:DC%2BD2cvnvFSmuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  15. AE Chapman MD Levitt P Hewett R Woods H Sheiner GJ Maddern (2001) ArticleTitleLaparoscopic-assisted resection of colorectal malignancies. A systematic review Ann Surg 234 590–606 Occurrence Handle11685021 Occurrence Handle10.1097/00000658-200111000-00003 Occurrence Handle1:STN:280:DC%2BD3MnmvFChsg%3D%3D

    Article  PubMed  CAS  Google Scholar 

  16. M Braga A Vignali W Zuliani et al. (2002) ArticleTitleMetabolic and functional results after laparoscopic colorectal surgery. A randomized, controlled trial Dis Colon Rectum 45 1070–7 Occurrence Handle12195192 Occurrence Handle10.1007/s10350-004-6362-2

    Article  PubMed  Google Scholar 

  17. HJ Duepree AJ Senagore CP Delaney VW Fazio (2003) ArticleTitleDoes means of access affect the incidence of small bowel resection? Laparoscopy versus laparotomy J Am Coll Surg 197 177–81 Occurrence Handle12892794 Occurrence Handle10.1016/S1072-7515(03)00232-1

    Article  PubMed  Google Scholar 

  18. R Bergamaschi P Pessaux JP Arnauld (2003) ArticleTitleComparison of conventional and laparoscopic ileocolic resection for Crohn's disease Dis Colon Rectum 46 1129–33 Occurrence Handle12907912 Occurrence Handle10.1007/s10350-004-7292-8

    Article  PubMed  Google Scholar 

  19. SD Ramsey MR Andersen R Etzioni et al. (2000) ArticleTitleQuality of life in survivors of colorectal carcinoma Cancer 88 1294–303 Occurrence Handle10717609 Occurrence Handle10.1002/(SICI)1097-0142(20000315)88:6<1294::AID-CNCR4>3.0.CO;2-M Occurrence Handle1:STN:280:DC%2BD3c7otlGjuw%3D%3D

    Article  PubMed  CAS  Google Scholar 

  20. WE Enker (1997) ArticleTitleTotal mesorectal excision, the new golden standard of surgery for rectal cancer Ann Med 29 127–33 Occurrence Handle9187227 Occurrence Handle1:STN:280:ByiA3s%2FnvFY%3D

    PubMed  CAS  Google Scholar 

  21. K Havenga WE Enker K McDermott (1996) ArticleTitleMale and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum J Am Coll Surg 182 495–502 Occurrence Handle8646349 Occurrence Handle1:STN:280:BymB2c3ht1w%3D

    PubMed  CAS  Google Scholar 

  22. D Osoba (1994) ArticleTitleLessons learned from measuring health-related quality of life in oncology J Clin Oncol 12 608–16 Occurrence Handle8120561 Occurrence Handle1:STN:280:ByuC28rmvFw%3D

    PubMed  CAS  Google Scholar 

  23. Streiner D, Norman G. Health measurement scales. A practical guide to their development and use. Oxford: Oxford University Press, 1989

  24. S Sultan DA Fisher CI Voils AY Kinney RS Sancler D Provenzale (2004) ArticleTitleImpact of functional support on health-related quality of life in patients with colorectal cancer Cancer 101 2737–43 Occurrence Handle15536617 Occurrence Handle10.1002/cncr.20699

    Article  PubMed  Google Scholar 

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Correspondence to Marco Braga M.D..

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Braga, M., Frasson, M., Vignali, A. et al. Laparoscopic vs. Open Colectomy in Cancer Patients: Long-Term Complications, Quality of Life, and Survival. Dis Colon Rectum 48, 2217–2223 (2005).

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