Abstract
Background/Aims
The minilaparotomy approach is feasible for the resection of colon cancer. This study aimed to compare the clinical and oncological outcomes of minilaparotomy and laparoscopic approaches in patients with colon cancer.
Methods
We performed a retrospective analysis of consecutive patients undergoing minilaparotomy or laparoscopic resection for colon cancer from January 2009 to December 2014.
Results
There were 376 patients with colon cancer. Seventy-one patients were excluded. The remaining 305 patients were allocated to the minilaparotomy (n = 146) group or laparoscopic group (n = 159). The demographic data of the two groups was similar except for body mass index. The time to first bowel movement (P = 0.000) and the hospital stay (P = 0.005) were less in the laparoscopic group. Compared with the minilaparotomy group, the mean operation time was longer and the costs higher for laparoscopic group (P = 0.000). The morbidity, mortality, and local recurrence were comparable between the two groups. The 5-year overall and disease-free survival rates were also similar (overall survival is 75.3 vs. 72.9%, P = 0.648; disease-free survival is 66.2 vs. 70.2%, P = 0.914).
Conclusion
The minilaparotomy approach was safe and equivalent to laparoscopic approach for patients with colon cancer. It is an alternative to the laparoscopic approach in selected patients.
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References
Jayne DG, Thorpe HC, Copeland J, et al. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg. 2010;97:1638–45.
Clinical Outcomes of Surgical Therapy Study G. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050–9.
Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6:477–84.
Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365:1718–26.
Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359:2224–9.
Avital S, Hermon H, Greenberg R, et al. Learning curve in laparoscopic colorectal surgery: our first 100 patients. Isr Med Assoc J. 2006;8:683–6.
Li JC, Leung KL, Ng SS, et al. Laparoscopic-assisted versus open resection of right-sided colonic cancer--a prospective randomized controlled trial. Int J Color Dis. 2012;27:95–102.
Baik SH, Gincherman M, Mutch MG, et al. Laparoscopic vs open resection for patients with rectal cancer: comparison of perioperative outcomes and long-term survival. Dis Colon rectum. 2011;54:6–14.
Hsu TC. Feasibility of colectomy with mini-incision. Am J Surg. 2005;190:48–50.
Takegami K, Kawaguchi Y, Nakayama H, et al. Minilaparotomy approach to colon cancer. Surg Today. 2003;33:414–20.
Nakagoe T, Sawai T, Tsuji T, et al. Colectomy for colon cancer via a 7-cm minilaparotomy. Surg Today. 2001;31:1113–5.
Nakagoe T, Sawai T, Tsuji T, et al. Early outcome after minilaparotomy for the treatment of rectal cancer. Eur J Surg. 2001;167:705–10.
Fleshman JW, Fry RD, Birnbaum EH, et al. Laparoscopic-assisted and minilaparotomy approaches to colorectal diseases are similar in early outcome. Dis Colon rectum. 1996;39:15–22.
Hewett PJ, Allardyce RA, Bagshaw PF, et al. Short-term outcomes of the Australasian randomized clinical study comparing laparoscopic and conventional open surgical treatments for colon cancer: the ALCCaS trial. Ann Surg. 2008;248:728–38.
Nakagoe T, Tsuji T, Sawai T, et al. Minilaparotomy may be independently associated with reduction in inflammatory responses after resection for colorectal cancer. Eur Surg Res. 2003;35:477–85.
Nakagoe T, Matsuo T, Nakamura S, et al. Risk factors preventing success of a minilaparotomy approach in the resection of colorectal cancer. Dig Surg. 2009;26:236–42.
Ishida H, Nakada H, Yokoyama M, et al. Minilaparotomy approach for colonic cancer: initial experience of 54 cases. Surg Endosc. 2005;19:316–20.
Cheng TO. Chinese body mass index is much lower as a risk factor for coronary artery disease. Circulation. 2004;109:e184. author reply e184
Menzies D, Ellis H. Intestinal obstruction from adhesions—how big is the problem? Ann R Coll Surg Engl. 1990;72:60–3.
Beck DE, Ferguson MA, Opelka FG, et al. Effect of previous surgery on abdominal opening time. Dis Colon rectum. 2000;43:1749–53.
Ranatunga KS, Fernando MA, Silva MA, et al. Use of minilaparotomy in the treatment of colonic cancer (Br J Surg 2001;88:831-6). Br J Surg. 2002;89:247–8.
Scheidbach H, Schneider C, Konradt J, et al. Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of the rectum. Surg Endosc. 2002;16:7–13.
Morino M, Parini U, Giraudo G, et al. Laparoscopic total mesorectal excision: a consecutive series of 100 patients. Ann Surg. 2003;237:335–42.
Ng SS, Leung KL, Lee JF, et al. Laparoscopic-assisted versus open abdominoperineal resection for low rectal cancer: a prospective randomized trial. Ann Surg Oncol. 2008;15:2418–25.
Jayne DG, Guillou PJ, Thorpe H, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC trial group. J Clin Oncol. 2007;25:3061–8.
Furstenberg S, Goldman S, Machado M, et al. Minilaparotomy approach to tumors of the right colon. Dis Colon rectum. 1998;41:997–9.
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This study was approved by the ethics committee of the Affiliated Hospital of North Sichuan Medical College.
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Informed consent was obtained from all individual participants included in the study.
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Liu, Z., Zhou, T., Yang, G. et al. Comparison of Clinical Outcomes Between Laparoscopic-Assisted and Minilaparotomy Approaches for Colon Cancer. J Gastrointest Canc 49, 158–166 (2018). https://doi.org/10.1007/s12029-017-9923-z
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DOI: https://doi.org/10.1007/s12029-017-9923-z