Evaluation of the Laparoscopic Colon Resection for Stage II and III Sigmoid Colon Cancer

Goutaro Katsuno, Masaki Fukunaga, Kunihiko Nagakari, Masahiko Sugano, Yoshifumi Lee, Masaru Suda, Yoshito Iida, Seiichirou Yoshikawa and Yoshinori Hirasaki

Department of Surgery, Juntendo Urayasu Hospital, Juntendo University

Background: Laparoscopy-assisted colectomy (LAC) for p stage 0-I colon cancer (LAC0-I) has become widely accepted, in Japan, but the oncological validity of this surgery remains to be well analyzed, especially for advanced cancer, and LAC for p stage II-III colon cancer (LACII-III) is not yet accepted. Objectives: Our objectives were to (1) compare LAC0-I and LACII-III safety and efficacy for sigmoid colon based on clinical outcome, i.e., intraoperative findings and perioperative and postoperative course, and (2) assess the oncological outcomes of LAP for p stage II-III sigmoid colon cancer. Methods: Subjects were 996 persons undergoing laparoscopic colorectal cancer surgery between March 1994 and January 2009. The cases of 231 cases whose pathological findings were curability A stage 0-III sigmoid colon cancer (0/I/II/IIIa/IIIb=17/81/68/41/24) were included in this study. Results: No significant statistical difference was seen in demographic data between LAC0-I and II-III. In LN dissection, LACII-III subjects required more D3. Results for other clinical outcomes were similar in both groups. Overall and disease-free 5-year survival was 100/99% in stage I, 96/94% in stage II, 93/89% in stage IIIa, and 85/76% in stage IIIb. Conclusions: Although further evaluation is required, laparoscopic surgery for p stage II/III sigmoid colon cancer appears to be safe, and oncologically adequate in treating colon cancer.

Key words
laparoscopy-assisted colectomy, sigmoid colon cancer, survival

Reprint requests
Goutaro Katsuno Department of Surgery, Juntendo Urayasu Hospital, Juntendo University
2-1-1 Tomioka, Urayasu, 279-0021 JAPAN

Accepted
September 16, 2009

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