Laparoscopic colorectal cancer resection and open colectomy provide similar long-term patients outcomes, according to a new report.
Laparoscopic resection of colorectal cancer is not performed commonly, the authors explain, because of concerns about oncological radicality and long-term outcome, according to the findings in the April 16th issue of the Cochrane Database of Systematic Reviews.
Dr. Esther Kuhry from Namsos Hospital in Norway and colleagues evaluated the long-term results of laparoscopic and conventional colorectal resection in a systematic review of 12 randomized controlled trials containing 3346 patients.
There were no significant differences between laparoscopic and open surgery in the occurrence of incisional hernia, the number of reoperations for incisional hernia, or the number of reoperations for intraperitoneal adhesions, the authors report.
Recurrences at the site of the primary tumor, the occurrence of port-site and wound metastases or peritoneal metastases, and the development of distant metastases did not differ between laparoscopic and open surgery, overall or when colon and rectal cancer were analyzed separately.
Cancer-related mortality and overall mortality were similar after laparoscopic and open surgery, the researchers note. Mortality rates did not differ for colon cancer, but there were insufficient data to analyze rectal cancer survival separately.
“Laparoscopic surgery for colon cancer is a safe procedure that is associated with a survival rate equal to survival after open surgery,” the investigators conclude. “The procedure can therefore be offered routinely to patients in hospitals where surgeons with sufficient experience in laparoscopic colon surgery are available.”
“In the case of rectal cancer,” they add, “data on long-term outcome are scarce and the results of large randomized trials have to be awaited.”
Cochrane Database of Systematic Reviews 2008;Art. No. CD003432.
Reviewed by Ramaz Mitaishvili, MD
