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Randomized controlled trial to evaluate laparoscopic versus open surgery in transverse and descending colon cancer patients

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

The safety and efficacy of laparoscopic surgery for transverse and descending colon cancer remain controversial. This study aimed to evaluate the short- and long-term outcomes of this procedure.

Methods

We conducted a single-institutional randomized controlled trial. Patients with transverse or descending colon cancer were randomly allocated to receive laparoscopic surgery (LAC) or conventional open surgery (OC). The primary endpoint was the overall complication rate between the two groups. The secondary endpoints were the length of the postoperative hospital stay, the health-related quality of life (HRQOL) score (at 1, 6, and 12 months after surgery), the 5-year relapse-free survival (RFS), and the 5-year overall survival (OS).

Results

Between August 2008 and October 2012, a total of 66 patients were enrolled (33 in the LAC group and 33 in the OC group). The patient characteristics showed no significant differences between the two groups. The complication rates (≥ grade 3) were 6.1% in the LAC group and 12.1% in the OC group (p = 0.392). The length of postoperative stay was not significantly different between the two groups. Regarding the HRQOL, the physical functioning, role physical, bodily pain, social functioning, mental health, and role component summary at 1 month after surgery and the social functioning and mental health at 6 months after surgery were better in the LAC group than in the OC group. The 5-year RFS and OS rates were similar between the LAC and OC groups (RFS 90.5% and 87.3%, respectively, p = 0.752; OS 93.3% and 100.0%, respectively, p = 0.543).

Conclusions

The short- and long-term outcomes of laparoscopic surgery for transverse and descending colon cancer are almost equal to those of open surgery. Laparoscopic resection is a better choice than open surgery for managing this cancer with regard to the short- and mid-term QOL.

Trial registration

ClinicalTrials.gov Identifier: NCT01861691.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medicine, Yokohama City University, Yokohama, Japan

    Kenichiro Toritani, Atsushi Ishibe, Mitsuyoshi Ota & Itaru Endo

  2. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Jun Watanabe, Kazuya Nakagawa, Yusuke Suwa, Shoichi Fujii & Chikara Kunisaki

  3. Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan

    Hirokazu Suwa

Authors
  1. Kenichiro Toritani
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  2. Jun Watanabe
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  3. Kazuya Nakagawa
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  4. Yusuke Suwa
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  5. Hirokazu Suwa
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  6. Atsushi Ishibe
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  9. Chikara Kunisaki
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  10. Itaru Endo
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Corresponding author

Correspondence to Jun Watanabe.

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The study protocol was approved by the Ethical Advisory Committee of Yokohama City University School of Medicine before the study was initiated.

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The authors declare that they have no conflict of interest.

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Toritani, K., Watanabe, J., Nakagawa, K. et al. Randomized controlled trial to evaluate laparoscopic versus open surgery in transverse and descending colon cancer patients. Int J Colorectal Dis 34, 1211–1220 (2019). https://doi.org/10.1007/s00384-019-03305-2

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