Clinical outcomes of laparoscopic surgery for advanced transverse and descending colon cancer: a single-center experience

Abstract

BackgroundThe role of laparoscopic surgery in management of transverse and descending colon cancer remains controversial. The aim of the present study is to investigate the short-term and oncologic long-term outcomes associated with laparoscopic surgery for transverse and descending colon cancer.MethodsThis cohort study analyzed 245 patients (stage II disease, n = 70; stage III disease, n = 63) who underwent resection of transverse and descending colon cancers, including 200 laparoscopic surgeries (LAC) and 45 conventional open surgeries (OC) from December 1996 to December 2010. Short-term and oncologic long-term outcomes were recorded.ResultsThe operative time was longer in the LAC group than in the OC group. However, intraoperative blood loss was significantly lower and postoperative recovery time was significantly shorter in the LAC group than in the OC group. The 5-year overall and disease-free survival rates for patients with stage II were 84.9% and 84.9% in the OC group and 93.7% and 90.0% in the LAC group, respectively. The 5-year overall and disease-free survival rates for patients with stage III disease were 63.4% and 54.6% in the OC group and 66.7% and 56.9% in the LAC group, respectively.ConclusionUse of laparoscopic surgery resulted in acceptable short-term and oncologic outcomes in patients with advanced transverse and descending colon cancer.

Laparoscopic versus open resection for transverse colon cancer

“…Table 5 summarizes the intraoperative outcomes of LR and OR [7,[9][10][11][12][13][14]. While most studies already published in the literature report a significantly longer operative time in the group of patients who had undergone LR than OR, [7,11,13], we did not observe significant differences between the two groups, most likely because almost all LR were performed by a single surgeon (M.…”

“…This variable was not evaluated in the other studies which, instead, reported mean proximal and distal resection margins, with no significant differences between the two approaches [7,9,[11][12][13][14]. Only Kim et al [10] found a mean distal margin of 12.5 cm in the LR versus 9.2 cm in the open surgery group (p \ 0.05).…”

“…The last 10 years have witnessed a trend of increasing utilization of LR surgery for colon cancer [6], and some small studies with short follow-up have compared the outcomes of LR and open resection (OR) in patients with transverse colon cancer [7][8][9][10][11][12][13][14][15][16].…”

Elective Surgery After Endoscopic Self-Expandable Metallic Stent Placement for Patients With Obstructive Colon Cancer: Preoperative Systemic Evaluation and Management

“…33,34 In the surgical procedures for obstructive colorectal cancers, the distended bowel is thought to restrict the appropriate surgical field, and the fragile bowel can be a risk factor for intraoperative injuries. In the present study, laparoscopic surgery was intended for 7 patients according to our tumor criteria, and all of these surgeries could be carried out without conversion to open surgery.…”

Preoperative Assessment of Vascular Anatomy by Multidetector Computed Tomography Before Laparoscopic Colectomy for Transverse Colon Cancer: Report of a Case

“…[1][2][3] However, the impact of several factors, such as obesity and transverse colon cancer, on the outcomes of laparoscopic colectomy poses some technical problems. [4][5][6][7] Patients with transverse colon cancer were often excluded from previous randomized controlled trials because it was difficult to determine the appropriate extent of lymph node dissection, and because the technical difficulties depend on the identification and lymph node dissection around the middle colic vessels, which have a variable anatomy. [5][6][7][8][9] The recent development of multidetector computed tomography (MDCT) has made it possible to perform three-dimensional CT angiography (3DCTA).…”