Skip to main content

Advertisement

SpringerLink
Log in

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

  • Original Article
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Schwenk W, Haase O, Neudecker JJ, Müller JM (2005) Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev 2. https://doi.org/10.1002/14651858.CD003145.pub2

  2. Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer J (2008) Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials. Cancer Treat Rev 34:498–504

    Article  PubMed  Google Scholar 

  3. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S (2009) Standardized surgery for colonic cancer: complete mesocolic excision and central ligation–technical notes and outcome. Color Dis 11:354–364

    Article  CAS  Google Scholar 

  4. Heald R (1995) Total mesorectal excision is optimal surgery for rectal cancer: a Scandinavian consensus. Brit J Surg 82:1297–1299

    Article  CAS  PubMed  Google Scholar 

  5. Watanabe T, Itabashi M, Shimada Y, Tanaka S, Ito Y, Ajioka Y, Hamaguchi T, Hyodo I, Igarashi M, Ishida H (2015) Japanese Society for cancer of the colon and rectum (JSCCR) guidelines 2014 for treatment of colorectal cancer. Int J Clin Oncol 20:207–239

    Article  PubMed  PubMed Central  Google Scholar 

  6. West NP, Kobayashi H, Takahashi K, Perrakis A, Weber K, Hohenberger W, Sugihara K, Quirke P (2012) Understanding optimal colonic cancer surgery: comparison of Japanese D3 resection and European complete mesocolic excision with central vascular ligation. J Clin Oncol 30:1763–1769

    Article  PubMed  Google Scholar 

  7. Lacy AM, García-Valdecasas JC, Delgado S, Castells A, Taurá P, Piqué JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359:2224–2229

    Article  PubMed  Google Scholar 

  8. Group COoSTS (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 2004:2050–2059

    Google Scholar 

  9. Group CCLoORS (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6:477–484

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  11. Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H (2007) Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg 246:655–664

    Article  PubMed  Google Scholar 

  12. Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, 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 

  13. Hewett PJ, Allardyce RA, Bagshaw PF, Frampton CM, Frizelle FA, Rieger NA, Smith JS, Solomon MJ, Stephens JH, Stevenson AR (2008) Short-term outcomes of the Australasian randomized clinical study comparing laparoscopic and conventional open surgical treatments for colon cancer: the ALCCaS trial. Ann Surg 248:728–738

    Article  PubMed  Google Scholar 

  14. Buunen M, Veldkamp R, Hop W, Kuhry E, Jeekel J, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 10:44–52

    Article  PubMed  Google Scholar 

  15. Jayne D, Thorpe H, Copeland J, Quirke P, Brown J, Guillou P (2010) Five-year follow-up of the medical research council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Brit J Surg 97:1638–1645

    Article  CAS  PubMed  Google Scholar 

  16. Yamamoto S, Inomata M, Katayama H, Mizusawa J, Etoh T, Konishi F, Sugihara K, Watanabe M, Moriya Y, Kitano S (2014) Short-term surgical outcomes from a randomized controlled trial to evaluate laparoscopic and open D3 dissection for stage II/III colon cancer: Japan clinical oncology group study JCOG 0404. Ann Surg 260:23–30. https://doi.org/10.1097/sla.0000000000000499

    Article  PubMed  Google Scholar 

  17. Mistrangelo M, Allaix ME, Cassoni P, Giraudo G, Arolfo S, Morino M (2015) Laparoscopic versus open resection for transverse colon cancer. Surg Endosc 29:2196–2202. https://doi.org/10.1007/s00464-014-3921-z

    Article  PubMed  Google Scholar 

  18. Sheng W, Zhang B, Chen W, Gu D, Gao W (2015) Laparoscopic colectomy for transverse colon cancer: comparative analysis of short-and long-term outcomes. Int J Clin Exp Med 8:16029

    PubMed  PubMed Central  Google Scholar 

  19. Kim JW, Kim JY, Kang BM, Lee BH, Kim BC, Park JH (2016) Short-and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study. Onco Targets Ther 9:2203

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kim WR, Baek SJ, Kim CW, Jang HA, Cho MS, Bae SU, Hur H, Min BS, Baik SH, Lee KY, Kim NK, Sohn SK (2014) Comparative study of oncologic outcomes for laparoscopic vs. open surgery in transverse colon cancer. Ann Surg Treat Res 86:28–34. https://doi.org/10.4174/astr.2014.86.1.28

    Article  PubMed  PubMed Central  Google Scholar 

  21. Fernandez-Cebrian JM, Gil Yonte P, Jimenez-Toscano M, Vega L, Ochando F (2013) Laparoscopic colectomy for transverse colon carcinoma: a surgical challenge but oncologically feasible. Colorectal Dis 15:e79–e83. https://doi.org/10.1111/codi.12067

    Article  CAS  PubMed  Google Scholar 

  22. Zhao L, Wang Y, Liu H, Chen H, Deng H, Yu J, Xue Q, Li G (2014) Long-term outcomes of laparoscopic surgery for advanced transverse colon cancer. J Gastrointest Surg 18:1003–1009. https://doi.org/10.1007/s11605-014-2462-z

    Article  PubMed  Google Scholar 

  23. Agarwal S, Gincherman M, Birnbaum E, Fleshman JW, Mutch M (2015) Comparison of long-term follow up of laparoscopic versus open colectomy for transverse colon cancer. Proc (Bayl Univ Med Cent) 28:296–299

    Google Scholar 

Download references

Source of funding

We have no source of support in the form of grants, equipment, drugs, or other means.

Author information

Authors and 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
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae Kyun Ju
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Soo Young Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chang Hyun Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Young Jin Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hyeong Rok Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

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.

Ethics declarations

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.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Accepted:

  • Published:

  • Issue Date:

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

Keywords

Search

Navigation