Laparoscopic versus open colorectal resections in patients with ...

Laparoscopic versus open colorectal resections in patients with symptomatic stage IV colorectal cancer.

Surg Endosc. 2012 Apr 5;

Authors: Allaix ME, Degiuli M, Giraudo G, Marano A, Morino M

Abstract

BACKGROUND: The purpose of this study was to evaluate short-term and oncologic outcomes of laparoscopic resection (LR) for patients with symptomatic stage IV colorectal cancer compared with open resection (OR). METHODS: This study is a retrospective analysis of a prospective database. Patients with a minimum follow-up of 12?months after LR or OR for metastatic colorectal cancer were included. All analyses were performed on an ?intention-to-treat? basis. RESULTS: A total of 162 consecutive patients submitted to LR and 127 submitted to OR were included. In the LR group, conversion rate was 26.5?%, mostly due to locally advanced disease (88.4?%). A greater risk of conversion was observed among patients with a tumor size greater than 5?cm regardless the tumor site (P?=?0.07). Early postoperative outcome was significantly better for LR group, with a shorter hospital stay (P?=?0.008), earlier onset of adjuvant treatment, and similar postoperative complications (P?=?0.853) and mortality rates (P?=?0.958). LR for rectal cancer was associated with a higher morbidity compared with colon cancer (P?=?0.058). During a median follow-up time of 72?months, there was no significant difference in overall survival between the two groups (P?=?0.622). CONCLUSIONS: LR for symptomatic metastatic CRC is safe and, compared with OR, is associated with a shorter hospital stay and with similar survival rates. Concerns remain about LR of bulky tumors and rectal cancers due to the increased risk of conversion and postoperative complications.

PMID: 22476839 [PubMed - as supplied by publisher]

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