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Published in: Surgical Endoscopy 8/2009

01-08-2009

A comparative study on the short-term clinicopathologic outcomes of laparoscopic surgery versus conventional open surgery for transverse colon cancer

Authors: H. J. Kim, I. K. Lee, Y. S. Lee, W. K. Kang, J. K. Park, S. T. Oh, J. G. Kim, Y. H. Kim

Published in: Surgical Endoscopy | Issue 8/2009

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Abstract

Background

The long-term oncologic stability of laparoscopic surgery for colon cancer was established, and laparoscopic surgery was accepted as an alternative to conventional open surgery for colon cancer. However, transverse colon cancer was excluded from the majority of the previous prospective studies. As a result, debate on laparoscopic surgery for transverse colon cancer continues. This study aimed to compare the clinicopathologic outcome of laparoscopic surgery with that of conventional open surgery for transverse colon cancer.

Methods

From August 2004 to December 2007, 106 cases of transverse colon cancer were managed by resection at our institution, and 89 of these cases were included in this study. Age, sex, body mass index (BMI), operation time, blood loss, time to first flatus, time to start of diet, hospital stay, complications, tumor size, distal resection margin, proximal resection margin, and number of nodes harvested were compared between the two groups.

Results

No significant differences were found between the laparoscopic and conventional groups in terms of age, sex, BMI, operation time, or hospital stay. The mean blood loss during the operations was significantly less in the laparoscopic group (113.8 ± 128.9 ml) than in the conventional group (278.8 ± 268.7 ml; p < 0.05). Moreover, the time to the first flatus was shorter (2.8 ± 0.9 days vs. 4.4 ± 2.0 days; p < 0.00) and the diet was started earlier (3.9 ± 1.7 days vs. 5.4 ± 1.9 days; p < 0.00) in the laparoscopic group. No intergroup differences in tumor size, proximal resection margin, or number of lymph nodes were observed. The mean distal resection margin was longer in the laparoscopic group (12.5 ± 4.1 cm vs. 9.2 ± 6.2 cm; p < 0.05).

Conclusion

Laparoscopic and conventional open surgeries were found to have similar clinical outcomes in transverse colon cancer, and the oncologic quality of laparoscopic surgery was found to be acceptable compared with conventional open surgery.
Literature
1.
go back to reference Cooperman AM, Katz V, Zimmon D, Botero G (1991) Laparoscopic colon resection: a case report. J Laparoendosc Surg 1:221–224PubMed Cooperman AM, Katz V, Zimmon D, Botero G (1991) Laparoscopic colon resection: a case report. J Laparoendosc Surg 1:221–224PubMed
2.
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
3.
go back to reference Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiqer E, Elson P (1998) A prospective randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187:46–54PubMedCrossRef Milsom JW, Bohm B, Hammerhofer KA, Fazio V, Steiqer E, Elson P (1998) A prospective randomized trial comparing laparoscopic versus conventional techniques in colorectal cancer surgery: a preliminary report. J Am Coll Surg 187:46–54PubMedCrossRef
4.
go back to reference Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomized trial. Lancet 363:1187–1192PubMedCrossRef Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomized trial. Lancet 363:1187–1192PubMedCrossRef
5.
go back to reference Guillou P, Quirke P, Thorpe H, Wakler J, Jayne DG, Smith AMH, Heath RM, Brown JM, CLASSICC for the MRC trial group (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASSIC trial): multicentre, randomized controlled trial. Lancet 365:1718–1726PubMedCrossRef Guillou P, Quirke P, Thorpe H, Wakler J, Jayne DG, Smith AMH, Heath RM, Brown JM, CLASSICC for the MRC trial group (2005) Short-term end points of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASSIC trial): multicentre, randomized controlled trial. Lancet 365:1718–1726PubMedCrossRef
6.
go back to reference The Colon Cancer Laparoscopic or Open Resection Study Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes for a randomized trial. Lancet 6:477–484CrossRef The Colon Cancer Laparoscopic or Open Resection Study Group (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes for a randomized trial. Lancet 6:477–484CrossRef
7.
go back to reference The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef The Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med 350:2050–2059CrossRef
8.
go back to reference Abraham NS, Byrne CM, Young JM, Solomon MJ (2007) Meta-analysis of nonrandomized comparative studies of the short-term outcomes of laparoscopic resection for colorectal cancer. ANZ J Surg 77:508–516PubMedCrossRef Abraham NS, Byrne CM, Young JM, Solomon MJ (2007) Meta-analysis of nonrandomized comparative studies of the short-term outcomes of laparoscopic resection for colorectal cancer. ANZ J Surg 77:508–516PubMedCrossRef
9.
go back to reference Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO Jr (2007) Laparoscopic versus open resection for colorectal cancer: a meta-analysis of oncologic outcomes. J Am Coll Surg 204:439–446PubMedCrossRef Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO Jr (2007) Laparoscopic versus open resection for colorectal cancer: a meta-analysis of oncologic outcomes. J Am Coll Surg 204:439–446PubMedCrossRef
10.
go back to reference Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef Abraham NS, Young JM, Solomon MJ (2004) Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 91:1111–1124PubMedCrossRef
11.
go back to reference American Joint Committee on Cancer (2002) AJCC Cancer staging manual, 6th edn. Springer-Verlad, New York American Joint Committee on Cancer (2002) AJCC Cancer staging manual, 6th edn. Springer-Verlad, New York
12.
go back to reference Japanese Society for Cancer of the Colon, Rectum (1997) Japanese classification of colorectal carcinoma. Kanehara & Co., Tokyo Japanese Society for Cancer of the Colon, Rectum (1997) Japanese classification of colorectal carcinoma. Kanehara & Co., Tokyo
13.
go back to reference Lee YS, Lee IK, Kang WK, Cho HM, Park JK, Oh ST, Kim JG, Kim YH (2008) Surgical and pathological outcomes of laparoscopic surgery for transverse colon cancer. Int J Colorectal Dis 23:669–673PubMedCrossRef Lee YS, Lee IK, Kang WK, Cho HM, Park JK, Oh ST, Kim JG, Kim YH (2008) Surgical and pathological outcomes of laparoscopic surgery for transverse colon cancer. Int J Colorectal Dis 23:669–673PubMedCrossRef
14.
go back to reference Fujita J, Uyama I, Squioka A, Komori Y, Matsui H, Hasumi A (2001) Laparoscopic right hemicolectomy with radical lymph node dissection using the no-touch isolation technique for advanced colon cancer. Surg Today 31:93–96PubMedCrossRef Fujita J, Uyama I, Squioka A, Komori Y, Matsui H, Hasumi A (2001) Laparoscopic right hemicolectomy with radical lymph node dissection using the no-touch isolation technique for advanced colon cancer. Surg Today 31:93–96PubMedCrossRef
15.
go back to reference Hasegawa S, Kawamura J, Nagayama S, Nomura A, Kondo K, Yoshiharu Y (2007) Medially approached radical lymph node dissection along the surgical trunk for advanced right-sided colon cancers. Surg Endosc 21:1657PubMedCrossRef Hasegawa S, Kawamura J, Nagayama S, Nomura A, Kondo K, Yoshiharu Y (2007) Medially approached radical lymph node dissection along the surgical trunk for advanced right-sided colon cancers. Surg Endosc 21:1657PubMedCrossRef
16.
go back to reference Beta I, Perko Z, Bokan I, Minica Z, Petriceive A, Druijanic N, Situm M (2005) Technique and survival after laparoscopically assisted right hemicolectomy. Surg Endosc 19:650–655CrossRef Beta I, Perko Z, Bokan I, Minica Z, Petriceive A, Druijanic N, Situm M (2005) Technique and survival after laparoscopically assisted right hemicolectomy. Surg Endosc 19:650–655CrossRef
17.
go back to reference Ichihara T, Takada M, Fukumoto S, Kuroda Y (2004) Lymphadenectomy along the middle colic artery in laparoscopic resection of transverse colon. Hepatogastroenterology 51:455–456 Ichihara T, Takada M, Fukumoto S, Kuroda Y (2004) Lymphadenectomy along the middle colic artery in laparoscopic resection of transverse colon. Hepatogastroenterology 51:455–456
18.
go back to reference Ignjatovic D, Stimec B, Finjord T, Bergamaschi R (2004) Venous anatomy of the right colon: three-dimensional topographic mapping of the gastrocolic trunk of Henle. Tech Coloproctol 8:19–22PubMedCrossRef Ignjatovic D, Stimec B, Finjord T, Bergamaschi R (2004) Venous anatomy of the right colon: three-dimensional topographic mapping of the gastrocolic trunk of Henle. Tech Coloproctol 8:19–22PubMedCrossRef
19.
go back to reference Jin G, Tuo H, Sugiyama M, Oki A, Abe N, Mori T, Masaki T, Atomi Y (2006) Anatomic study of the superior right colic vein: its relevance to pancreatic and colonic surgery. Am J Surg 191:100–103PubMedCrossRef Jin G, Tuo H, Sugiyama M, Oki A, Abe N, Mori T, Masaki T, Atomi Y (2006) Anatomic study of the superior right colic vein: its relevance to pancreatic and colonic surgery. Am J Surg 191:100–103PubMedCrossRef
20.
go back to reference Schlachta CM, Mamazza J, Poulin EC (2007) Are transverse colon cancers suitable for laparoscopic resection? Surg Endosc 21:396–399PubMedCrossRef Schlachta CM, Mamazza J, Poulin EC (2007) Are transverse colon cancers suitable for laparoscopic resection? Surg Endosc 21:396–399PubMedCrossRef
21.
go back to reference Hosono S, Ohtani H, Arimoto Y, Kanamiya Y (2007) Internal hernia with strangulation through a mesenteric defect after laparoscopic-assisted transverse colectomy: report of a case. Surg Today 34:330–334CrossRef Hosono S, Ohtani H, Arimoto Y, Kanamiya Y (2007) Internal hernia with strangulation through a mesenteric defect after laparoscopic-assisted transverse colectomy: report of a case. Surg Today 34:330–334CrossRef
Metadata
Title
A comparative study on the short-term clinicopathologic outcomes of laparoscopic surgery versus conventional open surgery for transverse colon cancer
Authors
H. J. Kim
I. K. Lee
Y. S. Lee
W. K. Kang
J. K. Park
S. T. Oh
J. G. Kim
Y. H. Kim
Publication date
01-08-2009
Publisher
Springer-Verlag
Published in
Surgical Endoscopy / Issue 8/2009
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-009-0348-z

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