All Title Author
Keywords Abstract

Outcome of Laparoscopic Resection for Left Sided Colon and Rectal Cancer

DOI: 10.4236/jct.2017.81005, PP. 51-63

Keywords: Laparoscopic Colorectal Surgery

Full-Text   Cite this paper   Add to My Lib


Background: For many years, traditional surgery for left colon and rectal cancers had developed with variable degrees of morbidity. With the evolution of laparoscopy and by the aid of better visualization and magnification, laparoscopic colorectal surgery had appeared, but technically challenging as it involves almost all advanced laparoscopic techniques, with the benefits of minimal morbidity, less pain, earlier recovery, shorter hospital stay, without compromising oncological results. Aim: The aim of this work was to evaluate laparoscopic resection for left sided colon and rectal cancer as regard feasibility, safety and outcomes. Patients and Methods: This prospective study was conducted on 40 patients having left sided colon and rectal cancer, including 29 patients with rectal cancer and 11 patients with left sided colon cancer within the inclusion criteria are evaluated by clinical examination, radiological and colonoscopic study and biopsy and treated by laparoscopic resection and followed ranged from 6 months to 2 years with mean of 20 months. Results: Twenty seven patients (67.5%) underwent laparoscopic anterior resection, 11 patients (27.5%) underwent laparoscopic left hemicolectomy and only 2 patients (5%) underwent laparoscopic abdominoperineal resection, minimal morbidity, no cancer related mortality and no recurrence during the period of follow up either local or systemic. Conclusion: Laparoscopic resection for left sided colon and rectal cancer is technically feasible, oncologically safe and has more benefits on postoperative recovery.


[1]  Labianca, R., Nordlinger, B., Beretta, G.D., et al. (2013) Early Colon Cancer: ESMO Clinical Practice Guidelines for Diagnosis, Treatment and Follow-Up. Annals of Oncology, 24, 64-72.
[2]  Sun, J., Jiang, T., Qiu, Z.J., et al. (2011) Short-Term and Medium-Term Clinical Outcomes of Laparoscopic-Assisted and Open Surgery for Colorectal Cancer: A Single Center Retrospective Case-Control Study. BMC Gastroenterology, 11, 85.
[3]  Curet, M.J. (2005) Laparoscopic-Assisted Resection of Colorectal Carcinoma. Lancet, 365, 1666-1668.
[4]  Pascual, M., Alonso, S., Parés, D., et al. (2011) Randomized Clinical Trial Comparing Inflammatory and Angiogenic Response after Open versus Laparoscopic Curative Resection for Colonic Cancer. British Journal of Surgery, 1, 50-59.
[5]  Berends, F.J., Kazemier, G., Bonjer, H.J., et al. (1994) Subcutaneous Metastases after Laparoscopic Colectomy. Lancet, 344, 358.
[6]  Wexner, S.D. and Cohen, S.M. (1995) Port Site Metastases after Laparoscopic Colorectal Surgery for Cure of Malignancy. British Journal of Surgery, 82, 295-298.
[7]  Rostirolla, R., Fontes, P., Pinho, M., et al. (2016) The Impact of Laparoscopic Surgery in Colorectal Cancer Resection with Respect to the Development of Liver Metastasis in the Long-Term. Journal of Coloproctology (Rio de Janeiro), 36, 8-15.
[8]  Lacy, M., Garcia, J.C., Delgado, S., et al. (2002) Laparoscopy-Assisted Colectomy versus Open Colectomy for Treatment of Non-Metastatic Colon Cancer: A Randomised Trial. Lancet, 359, 2224-2229.
[9]  Green, B.L., Marshall, H.C., Collinson, F., et al. (2013) Long-Term Follow up of the Medical Research Council CLASICC Trial of Conventional versus Laparoscopically Assisted Resection in Colorectal Cancer. British Journal of Surgery, 100, 75-82.
[10]  Kaltoft, B., Gogenur, I. and Rosenberg, J. (2011) Reduced Length of Stay and Convalescence in Laparoscopic versus Open Sigmoid Resection with Traditional Care: A Double Blinded Randomized Clinical Trial. Colorectal Disease, 13, 123-130.
[11]  Law, W.L., Lee, Y.M., Choi, H.K., et al. (2007) Impact of Laparoscopic Resection for Colorectal Cancer on Operative Outcomes and Survival. Annals of Surgery, 245, 1-7.
[12]  Araujo, S.E., Da Silva, A.H., de Campos, F.G., et al. (2003) Conventional Approach X Laparoscopic Abdominoperineal Resection for Rectal Cancer Treatment after Neoadjuvant Chemoradiation: Results of a Prospective Randomized Trial. Revista do Hospital das Clínicas, 58, 133-140.
[13]  Arezzo, A., Passera, R., Scozzari, G., Verra, M. and Morino, M. (2012) Laparoscopy for Rectal Cancer Reduces Short-Term Mortality and Morbidity: Results of a Systematic Review and Meta Analysis. Surgical Endoscopy, 27, 1485-1502.
[14]  Kirchhoff, P., Clavien, P. and Mahnloser, D. (2010) Complications in Colorectal Surgery: Risk Factors and Preventive Strategies. Patient Safety in Surgery, 4, 5.
[15]  Breukink, S., Pierie, J. and Wiggers, T. (2006) Laparoscopic versus Open Total Mesorectal Excision for Rectal Cancer. Cochrane Database of Systematic Reviews, 2006, CD005200.
[16]  Morino, M., Parini, U., Giraudo, G., et al. (2003) Laparoscopic Total Mesorectal Excision: A Consecutive Series of 100 Patients. Annals of Surgery, 237, 335-342.
[17]  Aziz, O., Constantinides, V., Tekkis, P.P., et al. (2006) Laparoscopic versus Open Surgery for Rectal Cancer: A Meta-Analysis. Annals of Surgical Oncology, 13, 413-424.
[18]  Kang, S.B., Park, J.W., Jeong, S.Y., et al. (2010) Open versus Laparoscopic Surgery for Mid or Low Rectal Cancer after Neoadjuvant Chemoradiotherapy (COREAN Trial). Lancet Oncology, 11, 637-645.
[19]  Kemp, J.A. and Finlayson, S.R. (2008) Outcomes of Laparoscopic and Open Colectomy: A National Population-Based Comparison. Surgical Innovation, 15, 277-283.
[20]  Veldkamp, R., Kuhry, E., Hop, W.C., et al. (2005) Laparoscopic Surgery versus Open Surgery for Colon Cancer: Short-Term Outcomes of a Randomised Trial. Lancet Oncology, 6, 477-484.
[21]  Aslani, N., Lobo-Prabhu, K., Heidary, B., et al. (2012) Outcomes of Laparoscopic Colon Cancer Surgery in a Population-Based Cohort in British Columbia: Are They as Good as the Clinical Trials? American Journal of Surgery, 204, 411-415.
[22]  Tonev, A., Kolev, N., Ignatov, V., Bojkov, V., Kirilova, T. and Ivanov, K. (2014) Chapter 5: Laparoscopy in the Management of Colorectal Cancer. In: Khan, J.S., Ed., Colorectal Cancer—Surgery, Diagnostics and Treatment, InTech.
[23]  Ng, S.S., Lee, J.F., Yiu, R.Y., et al. (2014) Long-Term Oncologic Outcomes of Laparoscopic versus Open Surgery for rectal Cancer: A Pooled Analysis of 3 Randomized Controlled Trials. Annals of Surgery, 259, 139-147.


comments powered by Disqus

Contact Us


微信:OALib Journal