Skip to main content
Top
Published in: Diseases of the Colon & Rectum 12/2005

01-12-2005 | Original Contribution

Laparoscopic vs. Open Colectomy in Cancer Patients: Long-Term Complications, Quality of Life, and Survival

Authors: Marco Braga, M.D., Matteo Frasson, M.D., Andrea Vignali, M.D., Walter Zuliani, M.D., Vittorio Civelli, M.D., Valerio Di Carlo, M.D.

Published in: Diseases of the Colon & Rectum | Issue 12/2005

Login to get access

PURPOSE

This study was designed to evaluate long-term complications, quality of life, and survival rate in a series of colorectal cancer patients randomized to laparoscopic or open surgery.

METHODS

A total of 391 patients with colorectal cancer were randomly assigned to laparoscopic (n = 190) or open (n = 201) resection. Long-term follow-up was performed every six months by office visits. Quality of life was assessed at 12, 24, and 48 months after surgery by a modified version of Short Form 36 Health Survey questionnaire. All patients were analyzed on an intention-to-treat basis.

RESULTS

Eight (4.2 percent) laparoscopic group patients needed conversion to open surgery. Overall long-term morbidity rate was 6.8 percent (13/190) in the laparoscopic vs. 14.9 percent (30/201) in the open group (P = 0.018). Overall quality of life was significantly better in the laparoscopic group in the first 12 months after surgery, whereas at 24 months, patients of the laparoscopic group reported a significant advantage only in social functioning. No difference was found in both overall and disease-free survival rates by comparing laparoscopic vs. open group.

CONCLUSIONS

Laparoscopic colorectal resection was associated with a lower incidence of long-term complications and a better quality of life in the first 12 months after surgery compared with open surgery. No difference between groups was found in overall and disease-free survival rates.
Literature
1.
go back to reference Braga, M, Vignali, A, Gianotti, L, et al. 2002Laparoscopic versus open colorectal surgery. A randomized trial on short-term outcomeAnn Surg23675967PubMedCrossRef Braga, M, Vignali, A, Gianotti, L,  et al. 2002Laparoscopic versus open colorectal surgery. A randomized trial on short-term outcomeAnn Surg23675967PubMedCrossRef
2.
go back to reference Lacy, AM, Garcia-Valdecasas, JC, Delgado, S, et al. 2002Laparoscopy–assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trialLancet35922249PubMedCrossRef Lacy, AM, Garcia-Valdecasas, JC, Delgado, S,  et al. 2002Laparoscopy–assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trialLancet35922249PubMedCrossRef
3.
go back to reference Leung, KL, Kwok, SP, Lam, SC, et al. 2004Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trialLancet363118792PubMedCrossRef Leung, KL, Kwok, SP, Lam, SC,  et al. 2004Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trialLancet363118792PubMedCrossRef
4.
go back to reference Nelson, H, Sargent, DJ, Wieand, HS, et al. 2004A comparison of laparoscopically assisted and open colectomy for colon cancerN Engl J Med35020509CrossRef Nelson, H, Sargent, DJ, Wieand, HS,  et al. 2004A comparison of laparoscopically assisted and open colectomy for colon cancerN Engl J Med35020509CrossRef
5.
go back to reference Psaila, J, Bulley, SH, Ewings, P, Sheffield, JP, Kennedy, RH 1998Outcome following laparoscopic resection for colorectal cancerBr J Surg856624PubMedCrossRef Psaila, J, Bulley, SH, Ewings, P, Sheffield, JP, Kennedy, RH 1998Outcome following laparoscopic resection for colorectal cancerBr J Surg856624PubMedCrossRef
6.
go back to reference Weeks, JC, Nelson, H, Gelber, S, Sargent, D, Schroeder, G 2002Short-term quality of life outcomes following laparoscopic-assisted colectomy vs. open colectomy for colon cancer: a randomized trialJAMA163218CrossRef Weeks, JC, Nelson, H, Gelber, S, Sargent, D, Schroeder, G 2002Short-term quality of life outcomes following laparoscopic-assisted colectomy vs. open colectomy for colon cancer: a randomized trialJAMA163218CrossRef
7.
go back to reference Thaler, K, Dinnewitzer, A, Mascha, E, et al. 2003Long-term outcome and health-related quality of life after laparoscopic and open colectomy for benign diseaseSurg Endosc1714048PubMedCrossRef Thaler, K, Dinnewitzer, A, Mascha, E,  et al. 2003Long-term outcome and health-related quality of life after laparoscopic and open colectomy for benign diseaseSurg Endosc1714048PubMedCrossRef
8.
go back to reference Braga, M, Vignali, A, Zuliani, W, et al. 2002Training period in laparoscopic colorectal surgery. A case-matched comparative study with open surgerySurg Endosc16315PubMedCrossRef Braga, M, Vignali, A, Zuliani, W,  et al. 2002Training period in laparoscopic colorectal surgery. A case-matched comparative study with open surgerySurg Endosc16315PubMedCrossRef
9.
go back to reference Bozzetti, F, Braga, M, Gianotti, L, Gavazzi, C, Mariani, L 2001Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trialLancet358148792PubMedCrossRef Bozzetti, F, Braga, M, Gianotti, L, Gavazzi, C, Mariani, L 2001Postoperative enteral versus parenteral nutrition in malnourished patients with gastrointestinal cancer: a randomised multicentre trialLancet358148792PubMedCrossRef
10.
go back to reference Ware, JE,Jr, Sherbourne, CD 1992The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selectionMed Care3047383PubMedCrossRef Ware, JE,Jr, Sherbourne, CD 1992The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selectionMed Care3047383PubMedCrossRef
11.
go back to reference Rauch, P, Miny, J, Conroy, T, Neyton, L, Guillemin, F 2004Quality of life among disease-free survivors of rectal cancerJ Clin Oncol2235460PubMedCrossRef Rauch, P, Miny, J, Conroy, T, Neyton, L, Guillemin, F 2004Quality of life among disease-free survivors of rectal cancerJ Clin Oncol2235460PubMedCrossRef
12.
go back to reference Arndt, V, Merx, H, Stegmaier, C, Ziegler, H, Brenner, H 2004Quality of life in patients with colorectal cancer 1 year after diagnosis compared with general population: a population-based studyJ Clin Oncol22482936PubMedCrossRef Arndt, V, Merx, H, Stegmaier, C, Ziegler, H, Brenner, H 2004Quality of life in patients with colorectal cancer 1 year after diagnosis compared with general population: a population-based studyJ Clin Oncol22482936PubMedCrossRef
13.
go back to reference Kopp, I, Bauhofer, A, Koller, M 2004Understanding quality of life in patients with colorectal cancer: comparison of data from a randomised controlled trial, a population based cohort study and the norm reference populationInflamm Res53S1305PubMedCrossRef Kopp, I, Bauhofer, A, Koller, M 2004Understanding quality of life in patients with colorectal cancer: comparison of data from a randomised controlled trial, a population based cohort study and the norm reference populationInflamm Res53S1305PubMedCrossRef
14.
go back to reference Abraham, NS, Young, JM, Solomon, MJ 2004Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancerBr J Surg91111124PubMedCrossRef Abraham, NS, Young, JM, Solomon, MJ 2004Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancerBr J Surg91111124PubMedCrossRef
15.
go back to reference Chapman, AE, Levitt, MD, Hewett, P, Woods, R, Sheiner, H, Maddern, GJ 2001Laparoscopic-assisted resection of colorectal malignancies. A systematic reviewAnn Surg234590606PubMedCrossRef Chapman, AE, Levitt, MD, Hewett, P, Woods, R, Sheiner, H, Maddern, GJ 2001Laparoscopic-assisted resection of colorectal malignancies. A systematic reviewAnn Surg234590606PubMedCrossRef
16.
go back to reference Braga, M, Vignali, A, Zuliani, W, et al. 2002Metabolic and functional results after laparoscopic colorectal surgery. A randomized, controlled trialDis Colon Rectum4510707PubMedCrossRef Braga, M, Vignali, A, Zuliani, W,  et al. 2002Metabolic and functional results after laparoscopic colorectal surgery. A randomized, controlled trialDis Colon Rectum4510707PubMedCrossRef
17.
go back to reference Duepree, HJ, Senagore, AJ, Delaney, CP, Fazio, VW 2003Does means of access affect the incidence of small bowel resection? Laparoscopy versus laparotomyJ Am Coll Surg19717781PubMedCrossRef Duepree, HJ, Senagore, AJ, Delaney, CP, Fazio, VW 2003Does means of access affect the incidence of small bowel resection? Laparoscopy versus laparotomyJ Am Coll Surg19717781PubMedCrossRef
18.
go back to reference Bergamaschi, R, Pessaux, P, Arnauld, JP 2003Comparison of conventional and laparoscopic ileocolic resection for Crohn's diseaseDis Colon Rectum46112933PubMedCrossRef Bergamaschi, R, Pessaux, P, Arnauld, JP 2003Comparison of conventional and laparoscopic ileocolic resection for Crohn's diseaseDis Colon Rectum46112933PubMedCrossRef
19.
go back to reference Ramsey, SD, Andersen, MR, Etzioni, R, et al. 2000Quality of life in survivors of colorectal carcinomaCancer881294303PubMedCrossRef Ramsey, SD, Andersen, MR, Etzioni, R,  et al. 2000Quality of life in survivors of colorectal carcinomaCancer881294303PubMedCrossRef
20.
go back to reference Enker, WE 1997Total mesorectal excision, the new golden standard of surgery for rectal cancerAnn Med2912733PubMed Enker, WE 1997Total mesorectal excision, the new golden standard of surgery for rectal cancerAnn Med2912733PubMed
21.
go back to reference Havenga, K, Enker, WE, McDermott, K 1996Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectumJ Am Coll Surg182495502PubMed Havenga, K, Enker, WE, McDermott, K 1996Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectumJ Am Coll Surg182495502PubMed
22.
go back to reference Osoba, D 1994Lessons learned from measuring health-related quality of life in oncologyJ Clin Oncol1260816PubMed Osoba, D 1994Lessons learned from measuring health-related quality of life in oncologyJ Clin Oncol1260816PubMed
23.
go back to reference Streiner D, Norman G. Health measurement scales. A practical guide to their development and use. Oxford: Oxford University Press, 1989 Streiner D, Norman G. Health measurement scales. A practical guide to their development and use. Oxford: Oxford University Press, 1989
24.
go back to reference Sultan, S, Fisher, DA, Voils, CI, Kinney, AY, Sancler, RS, Provenzale, D 2004Impact of functional support on health-related quality of life in patients with colorectal cancerCancer101273743PubMedCrossRef Sultan, S, Fisher, DA, Voils, CI, Kinney, AY, Sancler, RS, Provenzale, D 2004Impact of functional support on health-related quality of life in patients with colorectal cancerCancer101273743PubMedCrossRef
Metadata
Title
Laparoscopic vs. Open Colectomy in Cancer Patients: Long-Term Complications, Quality of Life, and Survival
Authors
Marco Braga, M.D.
Matteo Frasson, M.D.
Andrea Vignali, M.D.
Walter Zuliani, M.D.
Vittorio Civelli, M.D.
Valerio Di Carlo, M.D.
Publication date
01-12-2005
Publisher
Springer-Verlag
Published in
Diseases of the Colon & Rectum / Issue 12/2005
Print ISSN: 0012-3706
Electronic ISSN: 1530-0358
DOI
https://doi.org/10.1007/s10350-005-0185-7

Other articles of this Issue 12/2005

Diseases of the Colon & Rectum 12/2005 Go to the issue