Abstract
Introduction: Laparoscopy has increasing been used in treatment of colorectal cancers. Its benefits and adequacy as compared to open procedures continue to be investigated. The short term outcomes of laparoscopic and laparoscopy assisted colorectal surgeries are compared to open procedures.
Method: Patients undergoing colorectal surgeries were included in the study. The demographic and surgical parameters and outcomes were compared for laparoscopic and open approaches.
Results: The duration of surgery was longer for laparoscopic approach. While the duration of hospital stay, return of bowel function, requirement of blood transfusion, post operative ventilation requirement, wound infection, wound dehiscence, return to normal activities were favourable for laparoscopic procedures. The adequacy of resection and nodal clearance were comparable for both laparoscopic and open approaches
Conclusion: Laparoscopic approach is a feasible and safe procedure for colorectal surgeries when performed by a surgeon of adequate laparoscopic experience. The short term outcomes are in favour of laparoscopic approach.
References
- Siegel, D. Naishadham, and A. Jemal, “Cancer statistics, 2013,” CA: A Cancer Journal for Clinicians, vol. 63, no. 1, pp. 11–30, 2013
- L. Swanström and N. J. Soper, Eds., Mastery of Endoscopic and Laparoscopic Surgery, Lippincott Williams & Wilkins, Philadelphia, Pa, USA, 4th edition, 2014.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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
- 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.
- Bedirli A, Salman B, Yuksel O. Laparoscopic versus open surgery for colorectal cancer. A retrospective analysis of 163 patients in a single institution. Minim Invasive Surg. 2014;2014:530314
- 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
- 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
- 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.
- T. Nguyen and C. E. H. Scott-Conner, Eds., The SAGES Manual, Springer, New York, NY, USA, 3rd edition, 2012.
- 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.
- Köckerling, 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.
- 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.
- 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
- 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.
Corresponding Author
Dr Renjin RP
Assistant Professor, Govt Medical College, Kottayam
DOI: https://dx.doi.org/10.18535/jmscr/v5i8.62
