Background. The present study aimed to compare the clinical outcomes of laparoscopic versus open surgery for colorectal cancers. Materials and Methods. The medical records from a total of 163 patients who underwent surgery for colorectal cancers were retrospectively analyzed. Patient’s demographic data, operative details and postoperative early outcomes, outpatient follow-up, pathologic results, and stages of the cancer were reviewed from the database. Results. The patients who underwent laparoscopic surgery showed significant advantages due to the minimally invasive nature of the surgery compared with those who underwent open surgery, namely, less blood loss, faster postoperative recovery, and shorter postoperative hospital stay (). However, laparoscopic surgery for colorectal cancer resulted in a longer operative time compared with open surgery (). There were no statistically significant differences between groups for medical complications (). Open surgery resulted in more incisional infections and postoperative ileus compared with laparoscopic surgery (). There were no differences in the pathologic parameters between two groups (). Conclusions. These findings indicated that laparoscopic surgery for colorectal cancer had the clear advantages of a minimally invasive surgery and relative disadvantage with longer surgery time and exhibited similar pathologic parameters compared with open surgery. 1. Introduction Colorectal cancer remains the third most common cancer diagnosed and the third most common cause of cancer death in both sexes in industrialized nations [1]. Although many studies have suggested that laparoscopic surgery is superior to open surgery, the acceptance of this technique for colorectal cancer has been rather slow in clinical practice [2, 3]. One of the reasons for the low penetration of this procedure is laparoscopic colon resections which are technically demanding procedures and as such were initially prohibitive for the majority of surgeons [4]. To successfully complete each component of the operation (mobilization of colon, dissection and division of major vessels, removing the specimen, and anastomosis), the surgeon must possess advanced laparoscopic skills, including the ability to operate and recognize anatomy from multiple viewpoints [5]. Concerning the oncologic safety of the laparoscopic approach to colorectal cancers, multiple randomized controlled studies demonstrated that oncological outcomes of laparoscopic surgery were similar to open surgery [6, 7]. The benefits of laparoscopic colorectal surgery are seen in terms of
References
[1]
R. Siegel, D. Naishadham, and A. Jemal, “Cancer statistics, 2013,” CA: A Cancer Journal for Clinicians, vol. 63, no. 1, pp. 11–30, 2013.
[2]
J. D. Rea, M. M. Cone, B. S. Diggs, K. E. Deveney, K. C. Lu, and D. O. Herzig, “Utilization of laparoscopic colectomy in the United States before and after the clinical outcomes of surgical therapy study group trial,” Annals of Surgery, vol. 254, no. 2, pp. 281–288, 2011.
[3]
G. D. McKay, M. J. Morgan, S.-K. C. Wong et al., “Improved short-term outcomes of laparoscopic versus open resection for colon and rectal cancer in an area health service: a multicenter study,” Diseases of the Colon and Rectum, vol. 55, no. 1, pp. 42–50, 2012.
[4]
L. L. Swanstr？m and N. J. Soper, Eds., Mastery of Endoscopic and Laparoscopic Surgery, Lippincott Williams & Wilkins, Philadelphia, Pa, USA, 4th edition, 2014.
[5]
N. T. Nguyen and C. E. H. Scott-Conner, Eds., The SAGES Manual, Springer, New York, NY, USA, 3rd edition, 2012.
[6]
J. Fleshman, D. J. Sargent, E. Green et al., “Laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST Study Group trial,” Annals of Surgery, vol. 246, no. 4, pp. 655–662, 2007.
[7]
E. Kuhry, W. Schwenk, R. Gaupset, U. Romild, and J. Bonjer, “Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials,” Cancer Treatment Reviews, vol. 34, no. 6, pp. 498–504, 2008.
[8]
M. H. van der Pas, E. Haglind, M. A. Cuesta et al., “Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial,” The Lancet Oncology, vol. 14, no. 3, pp. 210–218, 2013.
[9]
D. G. Jayne, P. J. Guillou, H. Thorpe et al., “Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-Year results of the UK MRC CLASICC trial group,” Journal of Clinical Oncology, vol. 25, no. 21, pp. 3061–3068, 2007.
[10]
M. Buunen, R. Veldkamp, W. C. Hop, et al., “Survival after laparo-scopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial,” The Lancet Oncology, vol. 10, no. 1, pp. 44–52, 2009.
[11]
T. Lourenco, A. Murray, A. Grant, A. McKinley, Z. Krukowski, and L. Vale, “Laparoscopic surgery for colorectal cancer: safe and effective?—A systematic review,” Surgical Endoscopy and other Interventional Techniques, vol. 22, no. 5, pp. 1146–1160, 2008.
[12]
J. C. M. Li, A. W. I. Lo, S. S. F. Hon, S. S. M. Ng, J. F. Y. Lee, and K. L. Leung, “Institution learning curve of laparoscopic colectomy-a multi-dimensional analysis,” International Journal of Colorectal Disease, vol. 27, no. 4, pp. 527–533, 2012.
[13]
C. A. Vaccaro, G. L. Rossi, G. O. Quintana, E. R. Soriano, H. Vaccarezza, and F. Rubinstein, “Laparoscopic colorectal resections: a simple predictor model and a stratification risk for conversion to open surgery,” Diseases of the Colon & Rectum, vol. 57, no. 7, pp. 869–874, 2014.
[14]
R. R. Cima, I. Hassan, V. P. Poola et al., “Failure of institutionally derived predictive models of conversion in laparoscopic colorectal surgery to predict conversion outcomes in an independent data set of 998 laparoscopic colorectal procedures,” Annals of Surgery, vol. 251, no. 4, pp. 652–658, 2010.
[15]
C. Platell, N. Barwood, G. Dorfmann, and G. Makin, “The incidence of anastomotic leaks in patients undergoing colorectal surgery,” Colorectal Disease, vol. 9, no. 1, pp. 71–79, 2007.
[16]
C. E. Reinke, S. Showalter, N. N. Mahmoud, and R. R. Kelz, “Comparison of anastomotic leak rate after colorectal surgery using different databases,” Diseases of the Colon and Rectum, vol. 56, no. 5, pp. 638–644, 2013.
[17]
M. Kelly, A. Bhangu, P. Singh, J. E. F. Fitzgerald, and P. P. Tekkis, “Systematic review and meta-analysis of trainee—versus expert surgeon-performed colorectal resection,” British Journal of Surgery, vol. 101, no. 7, pp. 750–759, 2014.
[18]
F. K？ckerling, M. A. Reymond, C. Schneider et al., “Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer,” Diseases of the Colon and Rectum, vol. 41, no. 8, pp. 963–970, 1998.
[19]
K. Prakash, N. Kamalesh, K. Pramil, I. Vipin, A. Sylesh, and M. Jacob, “Does case selection and outcome following laparoscopic colorectal resection change after initial learning curve? Analysis of 235 consecutive elective laparoscopic colorectal resections,” Journal of Minimal Access Surgery, vol. 9, no. 3, pp. 99–103, 2013.
[20]
The Clinical Outcomes of Surgical Therapy Study Group, “A comparison of laparoscopically assisted and open colectomy for colon cancer,” The New England Journal of Medicine, vol. 350, no. 20, pp. 2050–2059, 2004.
[21]
R. Veldkamp, M. Gholghesaei, H. J. Bonjer et al., “Laparoscopic resection of colon cancer: consensus of the European Association of Endoscopic Surgery (E.A.E.S.),” Surgical Endoscopy and other Interventional Techniques, vol. 18, no. 8, pp. 1163–1185, 2004.
