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Feasibility of laparoscopic techniques as the surgical approach of choice for primary colorectal cancer

An analysis of 570 consecutive cases

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Abstract

Background

Since the Clinical Outcomes of Surgical Therapy (COST) trial data were reported in May 2004, the laparoscopic technique for primary colorectal cancer has been increasingly used and become the approach of choice at our center. This study aimed to evaluate our laparoscopic experience of 570 consecutive patients between October 2000 and December 2006, and assess the feasibility of this technique as the surgical approach of choice for primary colorectal cancer.

Methods

The study times were divided into three periods based on the COST trial report and the time when the laparoscopic technique was accepted as the surgical approach of choice at our center (period I: October 2000 to May 2004, II: June 2004 to December 2005, III: January to December 2006). Data regarding clinicopathological, surgical, and perioperative outcomes were collated from registry and compared between periods.

Results

The use of laparoscopic surgery increased from 2.4% in period I, to 19.2% in period II, to 66.1% in period III. Over the periods, the proportion of rectal cancer and right colon cancer increased (p < 0.001), T- and N-stage became more advanced (p < 0.001, p = 0.011 respectively), and operative time decreased (p < 0.001). The overall open conversion and morbidity rates were 3.5% and 9.8%, respectively, and these did not differ between periods.

Conclusion

It was possible to apply laparoscopic approach in two-thirds of primary colorectal cancer patients. The short-term favorable outcomes support the feasibility of laparoscopic technique as surgical approach of choice for colon cancer. Laparoscopic resection for rectal cancer may require a randomized clinical trial prior to gain similar acceptance.

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Acknowledgments

The authors would like to thank Dr. Woon Kyung Jeong, Dr. Sang-Woo Lim, M.D., Dr. Tae-Sung Chung, and Dr. Dong Hyun Choi for their extensive help and assistance in performing laparoscopic surgeries, and the staff at Center for Colorectal Cancer, National Cancer Center for their patience and assistance throughout this study.

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Author notes

  1. Jae-Gahb Park

    Present address: Department of Surgery, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744, Korea

Authors and Affiliations

  1. Center for Colorectal Cancer, Research Institute & Hospital, National Cancer Center, 809 Madu1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do, 410-769, Korea

    Seok-Byung Lim, Hyo Seong Choi, Seung-Yong Jeong & Jae-Gahb Park

Authors
  1. Seok-Byung Lim
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  2. Hyo Seong Choi
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  3. Seung-Yong Jeong
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  4. Jae-Gahb Park
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Corresponding author

Correspondence to Hyo Seong Choi.

Additional information

This work supported by National Cancer Center Grant 0610280.

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Lim, SB., Choi, H.S., Jeong, SY. et al. Feasibility of laparoscopic techniques as the surgical approach of choice for primary colorectal cancer. Surg Endosc 22, 2588–2595 (2008). https://doi.org/10.1007/s00464-008-9814-2

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  • DOI: https://doi.org/10.1007/s00464-008-9814-2

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