Comparison of Oncological Outcomes between Laparoscopic and Open Procedures in Non-Metastazing Colonic Carcinomas

Česká verzia

Authors: L. Martínek ; J. Dostalík; I. Guňka; P. Guňková; P. Vávra
Authors place of work: Chirurgická klinika FN Ostrava, přednosta: doc. MUDr. Jan Dostalík, CSc.
Published in the journal: Rozhl. Chir., 2009, roč. 88, č. 12, s. 725-729.
Category: Monothematic special - Original

Summary

Aim:
The aim of our study was to compare oncological results of laparoscopic assisted coloctomy and open colectomy in the treatment of nonmetastatic colon cancer.

Material and Methods:
In this prospective nonrandomised clinical trail a group of elective laparoscopic or open resections in patients with the colon adenocarcinom was evaluated in the period between January 2001 and December 2006. The primary endpoint was overall survival, disease free survival and recurrence.

Results:
A total of 220 patients were included in the analysis, of which 119 were operated laparoscopically and 101 by open technique. The median follow up period was 59 months (range 25–91) in the laparoscopic group and 68 months (range 25–96) in the open group (p = 0.0003). No statistically significant difference was found between the two treatment modalities regarding combined overall and disease-free survival for all stages (p = 0.16 resp. p = 0.27). With a respect of the tumor stage, there was a tendency of higher overall survival in favour of the laparoscopic group in the stage III, however the difference was not statistically significant (p = 0.07). During the follow up period the disease recurred in the laparoscopic and open group in 22 (18%), respective 20 (20%) patients (p = 0.78). The regression analysis showed that operative technique didn’t influence neither overall or disease-free survival (p = 0.16, respective p = 0.27).

Conclusion:
Long-term results support laparoscopic colon cancer surgery as a safe and effective alternative to open surgery.

Key words:
colon cancer – laparoscopy – survival

Zdroje

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