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Published in: International Journal of Colorectal Disease 3/2011

01-03-2011 | Original Article

Short-term outcomes following laparoscopic resection for colon cancer

Authors: Dara O. Kavanagh, David Gibson, Diarmaid C. Moran, Myles Smith, Kate O Donnell, Emmanuel Eguare, Frank B. V. Keane, Diarmaid S. O Riordain, Paul C. Neary

Published in: International Journal of Colorectal Disease | Issue 3/2011

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Abstract

Background

Laparoscopic resection for colon cancer has been proven to have a similar oncological efficacy compared to open resection. Despite this, it is performed by a minority of colorectal surgeons. The aim of our study was to evaluate the short-term clinical, oncological and survival outcomes in all patients undergoing laparoscopic resection for colon cancer.

Methods

From July 2005 to December 2008, 202 consecutive patients underwent laparoscopic resection for colon cancer. Surgery was analysed on an intention to treat basis. The mean follow-up was 24.3 months.

Results

Two hundred twenty-two patients underwent resection for colon cancer. Two hundred two underwent laparoscopic resection (91%). One hundred sixteen were male patients. Mean age was 65.9 years (range = 24–91). The median length of stay was 6.6 days (mean = 7.1 days). One hundred eighty-eight of 202 (93.1%) were completed laparoscopically. Fourteen (6.9%) were converted. The overall morbidity rate was 15.8%. There were three clinically apparent anastomotic leaks. The 30-day mortality was 1 (0.5%). The mean nodal yield was 13.4 (range = 8–37) nodes. There were no positive margins detected. Overall survival in laparoscopically treated colon cancer was 88.1%. In those patients with non-metastatic disease, the overall survival was 90.7% (165/182).

Conclusion

Laparoscopic resection for colon cancer is achievable in 85% (188/222) of patients. This facilitates adequate oncological clearance. It is associated with a low morbidity rate and favourable short-term survival outcomes. This data reflects the potential outcomes dedicated MIS colorectal units will have to offer colon cancer patients once laparoscopic colorectal surgery becomes the de facto surgical approach.
Literature
1.
go back to reference Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ (2003) Cancer statistics. CA Cancer J Clin 53:5–26CrossRefPubMed Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ (2003) Cancer statistics. CA Cancer J Clin 53:5–26CrossRefPubMed
2.
go back to reference Steele RJC (2005) Colorectal Surg 3:41–67, Elsevier Steele RJC (2005) Colorectal Surg 3:41–67, Elsevier
3.
go back to reference Schwenk W, Böhm B, Müller JM (1998) Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. a prospective randomized trial. Surg Endosc 12:1131–1136CrossRefPubMed Schwenk W, Böhm B, Müller JM (1998) Postoperative pain and fatigue after laparoscopic or conventional colorectal resections. a prospective randomized trial. Surg Endosc 12:1131–1136CrossRefPubMed
4.
go back to reference Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMed Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1:144–150PubMed
5.
go back to reference Stocchi L, Nelson H (1998) Laparoscopic colectomy for colon cancer: trial update. J Surg Oncol 68:255–267CrossRefPubMed Stocchi L, Nelson H (1998) Laparoscopic colectomy for colon cancer: trial update. J Surg Oncol 68:255–267CrossRefPubMed
6.
go back to reference Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Pique TP, JM VJ (2002) Laparoscopic-assisted colectomy versus open colectomy for the treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229CrossRefPubMed Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Pique TP, JM VJ (2002) Laparoscopic-assisted colectomy versus open colectomy for the treatment of non-metastatic colon cancer: a randomized trial. Lancet 359:2224–2229CrossRefPubMed
7.
go back to reference Lacy AM, Delgado S, Castells A, Prins HA, Arroyo V, Ibarzabal A, Pique JM (2008) The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg 248(1):1–7CrossRefPubMed Lacy AM, Delgado S, Castells A, Prins HA, Arroyo V, Ibarzabal A, Pique JM (2008) The long-term results of a randomized clinical trial of laparoscopy-assisted versus open surgery for colon cancer. Ann Surg 248(1):1–7CrossRefPubMed
8.
go back to reference Nelson H, Sargent DJ, Wienand HS, Fleshman J, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan RW, Ota D (2004) The clinical outcomes of surgical therapy study group. a comparison of laparoscopically assisted and open colectomy for colon cancer. New Engl J Med 350:2050–2059CrossRef Nelson H, Sargent DJ, Wienand HS, Fleshman J, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan RW, Ota D (2004) The clinical outcomes of surgical therapy study group. a comparison of laparoscopically assisted and open colectomy for colon cancer. New Engl J Med 350:2050–2059CrossRef
9.
go back to reference Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H (2007) For the clinical outcomes of surgical therapy study group. laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg 246(4):655–662, discussion 662-4CrossRefPubMed Fleshman J, Sargent DJ, Green E, Anvari M, Stryker SJ, Beart RW Jr, Hellinger M, Flanagan R Jr, Peters W, Nelson H (2007) For the clinical outcomes of surgical therapy study group. laparoscopic colectomy for cancer is not inferior to open surgery based on 5-year data from the COST study group trial. Ann Surg 246(4):655–662, discussion 662-4CrossRefPubMed
10.
go back to reference Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM (2005) Short-term endpoints of conventional vs. laparoscopic-assisted surgery in patients with colorectal cancer MRC-CLASICC trial: multicenter randomized controlled trial. Lancet 365:1718–1726CrossRefPubMed Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AMH, Heath RM, Brown JM (2005) Short-term endpoints of conventional vs. laparoscopic-assisted surgery in patients with colorectal cancer MRC-CLASICC trial: multicenter randomized controlled trial. Lancet 365:1718–1726CrossRefPubMed
11.
go back to reference Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AMH, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol 25:3061–3068CrossRefPubMed Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AMH, Heath RM, Brown JM (2007) Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol 25:3061–3068CrossRefPubMed
12.
go back to reference Delaney C, Neary P, Heriot A (2006) Operative techniques in laparoscopic colorectal surgery. Lippincott Williams & Wilkins, USA Delaney C, Neary P, Heriot A (2006) Operative techniques in laparoscopic colorectal surgery. Lippincott Williams & Wilkins, USA
13.
go back to reference Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left sided resections. Ann Surg 242:83–91CrossRefPubMed Tekkis PP, Senagore AJ, Delaney CP, Fazio VW (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left sided resections. Ann Surg 242:83–91CrossRefPubMed
14.
go back to reference Colon cancer Laparoscopic or Open Resection Study Group (COLOR) (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcomes of a randomized trial. Lancet Oncol 10:44–53CrossRef Colon cancer Laparoscopic or Open Resection Study Group (COLOR) (2009) Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcomes of a randomized trial. Lancet Oncol 10:44–53CrossRef
15.
go back to reference Lengyel J, Morrison C, Sagar PM (2010) Trends toward increased use of the laparoscopic approach in colorectal surgery. Colorectal Dis 12(10):1007–1012CrossRefPubMed Lengyel J, Morrison C, Sagar PM (2010) Trends toward increased use of the laparoscopic approach in colorectal surgery. Colorectal Dis 12(10):1007–1012CrossRefPubMed
16.
go back to reference Baker RP, Titu LV, Hartley JE, Lee PW, Monson JR (2004) A case–control study of laparoscopic right hemicolectomy vs. open right hemicolectomy. Dis Colon Rectum 47(10):1675–1679CrossRefPubMed Baker RP, Titu LV, Hartley JE, Lee PW, Monson JR (2004) A case–control study of laparoscopic right hemicolectomy vs. open right hemicolectomy. Dis Colon Rectum 47(10):1675–1679CrossRefPubMed
17.
go back to reference Scala A, Huang A, Dowson HM, Rockall TA (2007) Laparoscopic colorectal surgery—results from 200 patients. Colorectal Dis 9(8):701–705CrossRefPubMed Scala A, Huang A, Dowson HM, Rockall TA (2007) Laparoscopic colorectal surgery—results from 200 patients. Colorectal Dis 9(8):701–705CrossRefPubMed
18.
go back to reference Raymond T, Kumar S, Dastur J, Adamek J, Khot U, Stewart M, Parker M (2010) Case controlled study of the hospital stay and return to full activity following laparoscopic and open colorectal surgery before and after the introduction of an enhanced recovery programme. Colorectal Dis 12(10):1001–1006CrossRefPubMed Raymond T, Kumar S, Dastur J, Adamek J, Khot U, Stewart M, Parker M (2010) Case controlled study of the hospital stay and return to full activity following laparoscopic and open colorectal surgery before and after the introduction of an enhanced recovery programme. Colorectal Dis 12(10):1001–1006CrossRefPubMed
19.
go back to reference Lordan JT, Tilney HS, Shirol S, Jourdan I, Gudgeon AM (2008) Does the laparoscopic colorectal surgery learning curve adversely affect the results of colorectal cancer resection? A 3-year prospective study in a district general hospital. Colorectal Dis 10(4):363–369CrossRefPubMed Lordan JT, Tilney HS, Shirol S, Jourdan I, Gudgeon AM (2008) Does the laparoscopic colorectal surgery learning curve adversely affect the results of colorectal cancer resection? A 3-year prospective study in a district general hospital. Colorectal Dis 10(4):363–369CrossRefPubMed
20.
go back to reference Mirza MS, Longman RJ, Farrokhyar F, Sheffield JP, Kennedy RH (2008) Long-term outcomes for laparoscopic versus open resection of nonmetastatic colorectal cancer. J Laparoendosc Adv Surg Tech A 18(5):679–685CrossRefPubMed Mirza MS, Longman RJ, Farrokhyar F, Sheffield JP, Kennedy RH (2008) Long-term outcomes for laparoscopic versus open resection of nonmetastatic colorectal cancer. J Laparoendosc Adv Surg Tech A 18(5):679–685CrossRefPubMed
21.
go back to reference Mehigan B, White A, Winter DC, Sheehan KM, Hyland JM (2006) Laparoscopic colorectal resection: initial experience in a specialized unit. Ir Med J 99(7):211–214PubMed Mehigan B, White A, Winter DC, Sheehan KM, Hyland JM (2006) Laparoscopic colorectal resection: initial experience in a specialized unit. Ir Med J 99(7):211–214PubMed
22.
go back to reference Buchanan GN, Malik A, Parvaiz A, Sheffield JP, Kennedy RH (2008) Laparoscopic resection for colorectal cancer. Br J Surg 95:893–902CrossRefPubMed Buchanan GN, Malik A, Parvaiz A, Sheffield JP, Kennedy RH (2008) Laparoscopic resection for colorectal cancer. Br J Surg 95:893–902CrossRefPubMed
23.
go back to reference Neary PC, Boyle E, Delaney CP, Senagore AJ, Keane FB, Gallagher AG (2008) Construct validation of a novel hybrid virtual-reality simulator for training and assessing laparoscopic colectomy; results from the first course for experienced senior laparoscopic surgeons. Surg Endosc 22(10):2301–2309CrossRefPubMed Neary PC, Boyle E, Delaney CP, Senagore AJ, Keane FB, Gallagher AG (2008) Construct validation of a novel hybrid virtual-reality simulator for training and assessing laparoscopic colectomy; results from the first course for experienced senior laparoscopic surgeons. Surg Endosc 22(10):2301–2309CrossRefPubMed
24.
go back to reference ACPGBI. Guidelines for the Management of Colorectal Cancer, 3rd edn. The Association of Coloproctologists of Great Britain and Northern Ireland, London ACPGBI. Guidelines for the Management of Colorectal Cancer, 3rd edn. The Association of Coloproctologists of Great Britain and Northern Ireland, London
25.
go back to reference Boyle E, Ridgway PF, Keane FB, Neary P (2008) Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay. Colorectal Dis 10(9):911–915CrossRefPubMed Boyle E, Ridgway PF, Keane FB, Neary P (2008) Laparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stay. Colorectal Dis 10(9):911–915CrossRefPubMed
26.
go back to reference Phitayakorn R, Delaney CP, Reynolds HL, Champagne BJ, Heriot AG, Neary P, Senagore AJ, International Anastomotic Leak Study Group (2008) Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery. World J Surg 32(6):1147–1156CrossRefPubMed Phitayakorn R, Delaney CP, Reynolds HL, Champagne BJ, Heriot AG, Neary P, Senagore AJ, International Anastomotic Leak Study Group (2008) Standardized algorithms for management of anastomotic leaks and related abdominal and pelvic abscesses after colorectal surgery. World J Surg 32(6):1147–1156CrossRefPubMed
27.
go back to reference Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer HJ (2008). Long-term results of laparoscopic colorectal cancer resection. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD003432. doi: 10.1002/14651858.CD003432.pub2 Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer HJ (2008). Long-term results of laparoscopic colorectal cancer resection. Cochrane Database of Systematic Reviews, Issue 2. Art. No.: CD003432. doi: 10.​1002/​14651858.​CD003432.​pub2
28.
go back to reference Young-Fadok TM (2007) Colon cancer: trials, results, techniques (Lap and HALS), future. J Surg Oncol 96:651–659CrossRefPubMed Young-Fadok TM (2007) Colon cancer: trials, results, techniques (Lap and HALS), future. J Surg Oncol 96:651–659CrossRefPubMed
29.
go back to reference Liang JT, Huang KC, Lai HS, Lee PH, Jeng YM (2006) Oncologic results of laparoscopic versus conventional open surgery for stage II or III left-sided colon cancers: a randomized controlled trial. Ann Surg Oncol 14(1):109–117CrossRefPubMed Liang JT, Huang KC, Lai HS, Lee PH, Jeng YM (2006) Oncologic results of laparoscopic versus conventional open surgery for stage II or III left-sided colon cancers: a randomized controlled trial. Ann Surg Oncol 14(1):109–117CrossRefPubMed
30.
go back to reference Braga M, Frasson M, Vignali A, Zuliani W, Civelli V, Di Carlo V (2005) Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life and survival. Dis Col Rect 48:2217–2223CrossRef Braga M, Frasson M, Vignali A, Zuliani W, Civelli V, Di Carlo V (2005) Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life and survival. Dis Col Rect 48:2217–2223CrossRef
31.
go back to reference Naitoh T, Tsuchiya T, Honda H, Oikawa M, Saito Y, Hasegawa Y (2008) Clinical outcome of laparoscopic surgery for stage II and III colorectal cancer. Surg Endosc 22:950–954CrossRefPubMed Naitoh T, Tsuchiya T, Honda H, Oikawa M, Saito Y, Hasegawa Y (2008) Clinical outcome of laparoscopic surgery for stage II and III colorectal cancer. Surg Endosc 22:950–954CrossRefPubMed
Metadata
Title
Short-term outcomes following laparoscopic resection for colon cancer
Authors
Dara O. Kavanagh
David Gibson
Diarmaid C. Moran
Myles Smith
Kate O Donnell
Emmanuel Eguare
Frank B. V. Keane
Diarmaid S. O Riordain
Paul C. Neary
Publication date
01-03-2011
Publisher
Springer-Verlag
Published in
International Journal of Colorectal Disease / Issue 3/2011
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-010-1069-4

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