A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer

Nelson, Heidi; Sargent, Daniel J.; Wieand, Harry S.; Fleshman, James W.; Anvari, Mehran; Stryker, Steven J.; Beart, Robert W.; Hellinger, Michael D.; Flanagan, R.J.; Peters, Walter R.; Ota, David M.

doi:10.1056/nejmoa032651

Cited by 3,010 publications

(551 citation statements)

References 18 publications

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“…However, it is within the reported range (15 to 30 %) [6,8,37,38]. The reported hospital stay after laparoscopic CRC surgery is 5 to 8 days [6,8].…”

Section: Open Surgery Vs Laparoscopysupporting

confidence: 50%

“…However, it is within the reported range (15 to 30 %) [6,8,37,38]. The reported hospital stay after laparoscopic CRC surgery is 5 to 8 days [6,8]. In a meta-analysis of 7 trials, hospital stay after laparoscopic colon and rectal cancer resection has been analyzed separately and shown to be significantly shorter in both groups [35].…”

Section: Open Surgery Vs Laparoscopymentioning

confidence: 74%

“…The enthusiasm for laparoscopic colorectal resections for cancer suffered a setback when, in 1993, Alexander et al (4) reported the first case of wound recurrence three months after a right colectomy. Since 2002 four large RCTs have been published confirming the oncologic safety of laparoscopic compared with open colon cancer resection [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Surgery for Colorectal Cancer in Sri Lanka: Open to Laparoscopy

Priyantha

2018

Sri Lanka j Surg

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“…However, it is within the reported range (15 to 30 %) [6,8,37,38]. The reported hospital stay after laparoscopic CRC surgery is 5 to 8 days [6,8].…”

Section: Open Surgery Vs Laparoscopysupporting

confidence: 50%

Section: Open Surgery Vs Laparoscopymentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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Surgery for Colorectal Cancer in Sri Lanka: Open to Laparoscopy

Priyantha

2018

Sri Lanka j Surg

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“…Postoperative complications are observed in around 20% of patients who receive curative surgery with lymph node dissection for colorectal cancer 3, 4, 5, 6. Recent studies have shown that the postoperative complications were risk factors for the survival or disease recurrence in various types of malignancies 7, 8, 9, 10, 11, 12.…”

Section: Introductionmentioning

confidence: 99%

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

et al. 2017

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This study assessed the impact of postoperative complications on the colorectal cancer survival and recurrence after curative surgery using pooled individual patients’ data from three large phase III randomized trials. In total, 5530 patients were included in this study. The patients were classified as those with postoperative complications (C group) and those without postoperative complications (NC group). The risk factors for the overall survival (OS) and the disease‐free survival (DFS) were analyzed. Postoperative complications were found in 861 (15.6%) of the 5530 patients. The OS and DFS rates at 5 years after surgery were 68.9% and 74.8%, respectively, in the C group and 75.8% and 82.2%, respectively, in the NC group, values that were significantly different between the two groups (P < 0.001). The multivariate analysis demonstrated that postoperative complications were a significant independent risk factor for the OS and DFS. Postoperative complications can worsen the colorectal cancer survival and risk of recurrence. Surgical morbidity must be considered as a stratification factor in future phase III trials evaluating the effects of adjuvant chemotherapy on colorectal cancer.

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“…Furthermore, a subset analysis of a randomized trial showed a lower recurrence rate and better survival in patients with stage III colon cancer undergoing laparoscopic surgery compared with open surgery 13, 14, 15, 16, 17. In those studies, no additional procedure to cover serosal invasion to prevent the detachment of cancer cells to the peritoneal cavity was used during surgery in either approach.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic surgical challenge for T4a colon cancer

Seishi

Kawahara

Ogawa

et al. 2017

Annals of Gastroent Surgery

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For patients with T4a colon cancer, the risk of peritoneal dissemination after surgery remains unclear. Seven hundred and eleven patients with T3 or T4a colon cancer, 80 years of age or younger, underwent curative resection (open surgery in 512 and laparoscopic surgery in 199) at the four Jikei University hospitals between 2006 and 2012. Their risk factors for peritoneal dissemination after surgery were evaluated retrospectively. Number of lymph node metastases, postoperative liver metastases and postoperative peritoneal dissemination events in the T4a group were significantly greater than the number in the T3 group. Peritoneal dissemination after surgery developed in four patients (0.7%) in the T3 group and in six patients (5%) in the T4a group. Risk factors for peritoneal dissemination consisted of macroscopic type (P = 0.016), serosal invasion (P = 0.017) and number of lymph node metastases (P = 0.009) according to the Cox proportional hazards regression model. However, tumor diameter and surgical approach (laparoscopic vs open) were not significant factors for peritoneal dissemination. There were no significant differences between the postoperative relapse‐free survival rates for each surgical approach within the T3 or T4a group. Because of comparable postoperative peritoneal dissemination in T3 and T4a colon cancer by the surgical approach (laparoscopic or open), laparoscopic surgery for patients with T4a colon cancer seems justified.

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A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer

Abstract: In this multi-institutional study, the rates of recurrent cancer were similar after laparoscopically assisted colectomy and open colectomy, suggesting that the laparoscopic approach is an acceptable alternative to open surgery for colon cancer.

Cited by 3,010 publications

References 18 publications

Surgery for Colorectal Cancer in Sri Lanka: Open to Laparoscopy

Surgery for Colorectal Cancer in Sri Lanka: Open to Laparoscopy

Impact of postoperative complications on the colorectal cancer survival and recurrence: analyses of pooled individual patients’ data from three large phase III randomized trials

Laparoscopic surgical challenge for T4a colon cancer

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