Comparison between Laparoscopy-assisted Colectomy and Open Colectomy for Prognosis in Patients with Sigmoid and Rectosigmoid Carcinoma

Tarou Higuchi¹⁾²⁾, Kouki Otsuka¹⁾, Kentarou Fujisawa¹⁾, Tetsuya Itabashi¹⁾, Yuichirou Kawasaki¹⁾, Yuji Akiyama¹⁾, Hiroshi Asahi³⁾, Kazumi Okamoto⁴⁾, Kazuyoshi Saitou⁵⁾ and Go Wakabayashi¹⁾

First Department of Surgery, Iwate Medical University¹⁾
Department of Surgery, Saito-Rosai Hospital²⁾
Department of Surgery, Morioka Red Cross Hospital³⁾
Department of Surgery, Matsuzono Hospital⁴⁾
Department of Surgery, Saiseikai Kitakami Hospital⁵⁾

Purpose: The aim of this study was to compare the oncologic outcomes of laparoscopy-assisted colectomy (LAC) and open colectomy (OC) for colorectal cancer. Subjects: This retrospective, non-randomized study examined 88 patients who were cured with no residual tumors after undergoing a colorectal resection with a D3-dissection between January 1996 and March 2005. The patients were divided into 2 groups, those receiving a LAC (n=43) and those receiving an OC (n=45). The groups were compared with regard to blood loss, duration of surgery, lymph node yield, postoperative hospital stay, complications, recurrence, and survival rates. Results: None of the patients in the LAC group required conversion to OC in this study. Intra-operative blood loss was significantly lower for the LAC group (18 mL) than for the OC group (271 mL, P<0.0001), and the postoperative hospital stay was significantly shorter for the LAC group (13 days) than for the OC group (25 days, P<0.0001). The duration of surgery and the number of dissected lymph nodes were very similar between the groups. No significant differences in the rate of complication (LAC, 9.3%; OC, 22.2%; P=0.0976), the recurrence rate (LAC, 2.3%; OC, 11.1%; P=0.1022), the overall 5-year survival rate (LAC, 100%; OC, 93.2%; P=0.1064) or the disease-free 5-year survival rate (LAC, 95.2%; OC, 86.6%; P=0.1793) were observed between the groups. No perioperative deaths occurred in either group. Conclusions: Our findings suggest that LAC offers not only the better short-term prognosis but also a very similar oncologic outcomes to that of OC with regard to the middle-to-long-term prognosis for sigmoid and rectosigmoid carcinoma. We therefore expect that LAC could be equally effective as traditional OC for sigmoid and rectosigoid resection with D3-dissection from an oncologic point of view.

Key words
laparoscopy-assisted colectomy, open colectomy, sigmoid and rectosigmoid cancers, oncologic resection, survival rates

Reprint requests
Tarou Higuchi Department of Surgery, Saito-Rosai Hospital
1-12-7 Doujouminami, Chuo-ku, Chiba, 260-0005 JAPAN

Accepted
April 26, 2006

To read the PDF file you will need Abobe Reader installed on your computer.