Laparoscopic versus Open Surgery for Colorectal Cancer: Oncologic and Short-term Clinical Outcomes in a Thai Tertiary-care Hospital

Authors

  • Panuwat Lertsithichai Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Theerapol Angkoolpakdeekul Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
  • Thana Ekwongviriya Department of Surgery, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Laparoscopy, colorectal cancer, oncology, outcome organs in the pelvis, less tissue trauma and blood loss

Abstract

Objective: To compare the short-term operative and oncologic outcomes of laparoscopic surgery with those of open surgery in patients with colorectal cancer in a Thai tertiary-care hospital.

Methods: Medical records of 84 patients (36 laparoscopic and 48 open surgery) treated between January 2003 and October 2007 were reviewed. Patients younger than 18 years or harboring major medical co-morbidities were excluded. Baseline clinical characteristics, operative and postoperative events, details of pathological specimens and follow-up information such as cancer recurrence or death were reviewed.

Results: All clinical characteristics did not differ significantly between the two groups. Proximal and distal margins of surgical specimens as well as the total number of lymph nodes removed (median number 19 for laparoscopic vs. 17 for open surgery) were also similar. There were no significant differences in postoperative complications, and after a median follow-up time of 7.5 months and 12 months for the laparoscopic and open procedures respectively, no significant differences in the recurrence rates were seen. There were no operative or cancer-related deaths.

Conclusion: There was no evidence that operative and early oncologic outcomes differ between laparoscopic and open surgery for colorectal cancer patients in a Thai tertiary-care hospital.

References

1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy), Surg Laparosc Endosc 1991:1:144-50.

2. Jackson TD, Kaplan GG, Arena G, et al.Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg 2007:204:439-46.

3. Transatlantic Laparoscopically Assisted vs Open Colectomy Trials Study Group. Laparoscopically assisted vs. open colectomy for colon cancer: a meta-analysis. Arch Surg 2007;142:298-303.

4. Kahnamoui K, Cadeddu M, FarrokhyarF, et al. Laparoscopic surgery for colon cancer: a systematic review. Can J Surg 2007;50:48-57.

5. Fingerhut A, Ata T, Chouillard E, et al. Laparoscopic approach to colonic cancer: critical appraisal of the literature, Dig Dis 2007:25:33-43.

6. Abraham NS, Byrne CM, Young JM, et al, Meta-analysis of non-randomized comparative studies of the short-term outcomes of laparoscopic resection for colorectal cancer. ANZ J Surg 2007;77:508-16.

7. The COlon cancer Laparoscopic or Open Resection (COLOR) Study Group. Laparoscopic versus open surgery for colon cancer: short-term outcomes of a randomized trial. Lancet Oncol 2005;6:477-84.

8. Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopic-aassisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. JClin Oncol 200725:3061-8.

9. Fleshman J, Sargent DJ, Green E, et al., for the COST 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 2007:246:655-64.

10. Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M, eds. AJCC cancer staging manual. 6th ed. New York: Springer-Verlag, 2002.

11. Chung CC, Chung CKN, Tsang WWC, et al. Hand-assisted laparoscopic versus open right colectomy: a randomized controlled trial. Ann Surg 2007,246:728-33.

12. Janson M, Lindholm E, Anderberg B, et al. Randomized trial of health-related quality of life after open and laparoscopic surgery for colon cancer, Surg Endosc 2007:21:747-53.

13. Franks PJ, Bosanquet N, Thorpe H, et al. Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer 2006:95:6-12.

14. Hayes JL, Hansen P, Is laparoscopic colectomy for cancer cost-effective relative to open colectomy? ANZ J Surg 2007:77:782-6.

15. Braga M, Frasson M, Vignali A, et al. Open right colectomy is still effective compared to laparoscopy: results of a randomized trial. Ann Surg 2007:246:1010-5.

16. The Clinical Outcomes of Surgical Therapy (COST, Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer.N Engl J Med 2004;350:2050-9.

17. Gonzalez IA, Luis HD, Malagon AM, et al. A comparative study of short-term results of laparoscopic surgery for rectal cancer during the learning curve, In J Colorectal Dis 2006;21:590-5.

Downloads

Published

2008-12-29

How to Cite

1.
Lertsithichai P, Angkoolpakdeekul T, Ekwongviriya T. Laparoscopic versus Open Surgery for Colorectal Cancer: Oncologic and Short-term Clinical Outcomes in a Thai Tertiary-care Hospital. Thai J Surg [Internet]. 2008 Dec. 29 [cited 2024 Mar. 28];29(4):197-43. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/241043

Issue

Section

Original Articles