Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution

Abstract

The oncologic merits of the laparoscopic technique for colorectal cancer surgery remain debatable. Eligible patients with non-metastatic colorectal cancer who were scheduled for an elective resection by one surgeon in a medical institution were randomized to either laparoscopic or open surgery. During this period, a total of 188 patients received laparoscopic surgery and the other 163 patients received the open approach. The primary endpoint was cancer-free five-year survival after operative treatment, and the secondary endpoint was the tumor recurrence incidence. Besides, surgical complications were also compared. There was no statistically significant difference between open and laparoscopic groups regarding the average number of lymph nodes dissected, ileus, anastomosis leakage, overall mortality rate, cancer recurrence rate, or cancer-free five-year survival. Even though performing a laparoscopic approach used a significantly longer operation time, this technique was more effective for colorectal cancer treatment in terms of shorter hospital stay and less blood loss. Meanwhile, fewer patients receiving the laparoscopic approach developed postoperative urinary tract infection, wound infection, or pneumonia, which reached statistical significance. For non-metastatic colorectal cancer patients, laparoscopic surgery resulted in better short-term outcomes, whether in several surgical complications and intra-operative blood loss. Though there was no significant statistical difference in terms of cancer-free five-year survival and tumor recurrence, it is strongly recommended that patients undergo laparoscopic surgery if not contraindicated.

Video-Laparoscopic versus Open Surgery in Obese Patients with Colorectal Cancer: A Propensity Score Matching Study

“…Oncologically speaking, obesity [ 3 ], reduced physical activity [ 4 , 5 ], Western diet [ 6 ], and diabetes [ 7 ] are the main factors involved in the increased incidence of CRC. From a surgical perspective, minimally invasive surgery has gradually become a standard treatment for patients diagnosed with colorectal cancer, ever since the first video-laparoscopic (VL) colorectal resection reported by Jacobs in 1991 [ 8 ].…”

<p>Enteric-Coated Strategies in Colorectal Cancer Nanoparticle Drug Delivery System</p>

“…Besides, the usual risks of surgery such as major blood loss and infections, colectomy might lead to serious tissue damage causing leakage of the anastomosis. [12][13][14][15][16][17][18][19] It is also worth mentioning that the risk of fecal and urinary incontinence after radiation therapy is high. 5,[20][21][22][23][24][25] Another problem associated with radiotherapy and chemotherapy is tissue toxicity as both cancerous and healthy cells are affected.…”

Laparoscopic technique of lateral pelvic lymph node dissection in locally advanced rectal cancer — a video vignette

“…Results from previous studies have shown that laparoscopic lateral pelvic lymphadenectomy for rectal cancer has less perioperative blood loss and fewer postoperative complications compared with open lateral pelvic dissection [5]. There was no difference in the oncological outcomes between the two techniques [6].…”