Laparoscopic Versus Open Resection for Colorectal Cancer: A Metaanalysis of Oncologic Outcomes

Jackson, Timothy; Kaplan, Gilaad G.; Arena, Goffredo; Page, John H.; Rogers, Selwyn O.

doi:10.1016/j.jamcollsurg.2006.12.008

Cited by 119 publications

(75 citation statements)

References 28 publications

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“…Moreover, positive resection margins were found in 2.1% of open colectomy specimens vs 1.3% of laparoscopic specimens (odds ratio, 1.8; 95% CI: 0.7-4.5; P = 0.23). These findings are mirrored in the study published by Jackson and colleagues [11] . The question raised by the earliest series as to whether port-site metastases or other forms of recurrence would cause inferior oncologic outcomes from laparoscopy-assisted colon resection as compared with open surgery now appears to be resolved [12][13][14] .…”

Section: Discussionsupporting

confidence: 71%

Long-term outcomes after laparoscopic colectomy

Braga¹,

Pecorelli²,

Frasson³

et al. 2011

WJGO

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AIM:To evaluate long-term outcomes in a large series of patients who randomly received laparoscopic or open colorectal resection. METHODS: From February 2000 to December 2004, six hundred sixty-two patients with colorectal disease were randomly assigned to laparoscopic (LPS, n = 330) or open (n = 332) colorectal resection. All patients were analyzed on an intention-to-treat basis. Long-term follow-up was carried out every 6 mo by office visits. In 526 cancer patients five-year overall and disease-free survival were evaluated. Median oncologic follow-up was 96 mo. RESULTS:Eight (4.2%) LPS group patients needed conversion to open surgery. Overall long-term morbidity rate was 7.6% (25/330) in the LPS vs 11.1% (37/332) in the open group (P = 0.17). In cancer patients, fiveyear overall survival was 68.6% in the LPS group and 64.0% in the Open group (P = 0.27). Excluding stage Ⅳ patients, five-year local and distant recurrence rates were 32.5% in the LPS group and 36.8% in the Open group (P = 0.36). Further, no difference in recurrence rate was found when patients were stratified according to cancer stage. CONCLUSION:LPS colorectal resection was associated with a slightly lower incidence of long-term complications than open surgery. No difference between groups was found in overall and disease-free survival rates.

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Section: Discussionsupporting

confidence: 71%

Long-term outcomes after laparoscopic colectomy

Braga¹,

Pecorelli²,

Frasson³

et al. 2011

WJGO

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“…Regarding SIL-RH, approximately 69 % of patients underwent SIL-RH for colon cancer (Table 1). Conventional MLC has been proven to be oncologically equivalent to OC, in terms of recurrence and survival [53,[60][61][62]. Therefore, any new surgical treatment against colon cancer has to be evaluated in terms of oncological radicalness, compared with MLC, which till nowadays serves as a gold standard [50,[63][64][65][66].…”

Section: Discussionmentioning

confidence: 99%

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Αποστόλου

Orfanos²,

Papalois

et al. 2015

Indian J Surg

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As surgeons became more adept with laparoscopic colon surgery, other less invasive procedures, such as singleincision laparoscopic right hemi-colectomy (SIL-RH), have been applied. The objective of this study was to evaluate the safety of SIL-RH as well as its intraoperative and postoperative outcomes for right-sided colon diseases. A detailed search in PubMed for citations that included SIL-RH from 2000 to 2014 revealed 21 studies fulfilling the criteria of the present review. A total of 684 patients were analyzed. Of the patients, 50.2 % were men. Mean patient age was 64.8 years. Of the patients, 36.1 % had already undergone an abdominal operation before the performance of SIL-RH, while 69 % of the patients underwent SIL-RH for colon cancer. Relatively low rates of overall morbidity (15 %) and mortality (0.75 %) were reported in the included studies. Mean length of postoperative hospital stay (LOS) was 5.5 days. Bowel motility return had a mean value of 2.8 days. Mean number of harvested lymph nodes (LN) was 19.2 LN. All resection margins were tumorfree. SIL-RH was a safe alternative to multiport laparoscopic right hemi-colectomy (ML-RH) in terms of morbidity and mortality, postoperative gastrointestinal function recovery, LOS, as well as oncological radicalness.

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“…An example of the beneficial effects of stress reduction is the use of laparascopic as opposed to open abdominal surgery for tumor resection. The reduced stress response with laparascopic surgery has been linked to reductions in immunosuppression and tumor recurrence [23,28,29]. However, the proposed benefit of regional anesthesia on reducing metastasis and cancer recurrence is not solely attributed to its attenuation of the stress response to surgery.…”

Section: The Effects Of Surgical Stress On the Hostmentioning

confidence: 99%

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

Le-Wendling

Nin

Capdevila³

2016

Pain Med

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Objective. More than one million people each year in the United States are diagnosed with cancer. Surgery is considered curative, but the perioperative phase represents a vulnerable period for residual disease to spread. Regional anesthesia has been proposed to reduce the incidence of recurrence by attenuating the sympathetic nervous system's response during surgery, reducing opioid requirements thus diminishing their immunosuppressant effects, and providing antitumor and antiinflammatory effects directly through systemic local anesthetic action. In this article, we present a description of the perioperative period, a summary of the proposed hypotheses and available literature on the effects of regional anesthesia on cancer recurrence, and put regional anesthesia in context in regard to its potential role in reducing cancer recurrence during the perioperative period.Methods. A literature review was conducted through PubMed by examining the following topics: effects of surgery on tumor progression, roles of multiple perioperative variables (analgesics, hypothermia, blood transfusion, beta-blockade) in cancer recurrence, and available in vitro, animal, and human studies regarding the effects of regional anesthesia on cancer recurrence.Results. in vitro, animal and human retrospective studies suppport the hypothesis that in certain types of cancer, regional anesthesia may be associated with lower recurrence rates. A few well-planned human randomized clinical trials are currently under way that may provide more solid evidence to substantiate or refute the benefits of regional anesthesia in reducing cancer recurrence.Conclusions. The benefits of regional anesthesia in reducing cancer recurrence have a sound theoretical basis and, in certain cancers, are supported by the existing body of literature. This article outlines the current state of our knowledge on the relationship between cancer progression and regional analgesia.

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Laparoscopic Versus Open Resection for Colorectal Cancer: A Metaanalysis of Oncologic Outcomes

Cited by 119 publications

References 28 publications

Long-term outcomes after laparoscopic colectomy

Long-term outcomes after laparoscopic colectomy

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Cancer Recurrence and Regional Anesthesia: The Theories, the Data, and the Future in Outcomes

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