Open colectomy versus laparoscopic-assisted colectomy supported by hand-assisted laparoscopic colectomy for resectable colorectal cancer: a comparative study with minimum follow-up of three years

Hepatogastroenterology. 2009 Jul-Aug;56(93):998-1006.

Abstract

Background/aims: Although laparoscopic colorectal cancer surgery is not widely used for several reasons especially for concerning inadequate resection, recent data showed equivalent oncologic outcomes between open colectomy (OC) and laparoscopic-assisted colectomy (LAC). However, there is no clinical trial for the LAC supported by hand-assisted laparoscopic colectomy (HALC), named as LAC/HALC.

Methodology: Patients were assigned to either OC or LAC/HALC group. Clinical data, operation times, conversion rates from LAC to HALC, complications, early results, and long-term results were analyzed retrospectively.

Results: The short-term outcomes including pain, ambulation, oral resumption, wound infections, and hospital stays were favorable for LAC/HALC group. HALC was subsequently required in seven LAC cases but none of them required open colectomies. Functional recovery was the benchmark for early discharge for LAC/HALC group. Specimen size and number of lymph nodes harvested were similar. Local recurrence, disease-free and overall survival rates were comparable.

Conclusion: The current study demonstrated that LAC/HALC was associated with favorable recoveries even in oncologic clearance in the long-term follow-up. HALC reduces the conversion rate from LAC to OC and maintains the benefits of minimal invasive surgery. Therefore, we suggest LAC/HALC is a suitable surgical hybrid for the treatment of resectable colorectal cancers.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Colectomy / methods*
  • Colorectal Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy
  • Length of Stay / statistics & numerical data
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Pain Measurement
  • Postoperative Complications
  • Retrospective Studies
  • Treatment Outcome