Page 14 - WALS Journal

10.5005/jp-journals-10033-1164
Hana Alhomoud, Oscar Manuel Torres Falcon
REVIEW ARTICLE
Laparoscopic assisted vs Open Surgery for Colon Cancer

Hana Alhomoud, Oscar Manuel Torres Falcon

ABSTRACT used: ‘Laparoscopy’, ‘laparoscopy-assisted’, ‘surgery’,
‘colorectal cancer’.
Purpose: A review article to evaluate and compare the short-
and long-term results of laparoscopic-assisted colectomy ( LAC)
and open colectomy (OC) for colon cancer. RESULTS
Materials and methods: Relevant papers were searched using Twelve RCT that compared LAC and OC for colon cancer
MEDLINE,Science Citation Index and Cochrane Controlled Trial 9-28
Register, by using the search terms ‘laparoscopy’, ‘surgery’, were identified. The results of the outcomes over short-
‘colectomy’ and ‘colon cancer’. and long-term periods are reported below.
Conclusion: LAC has the benefits of reducing intraoperative
blood loss, earlier resumption of oral intake and shorter duration Short-term Outcomes
of hospital stay.
Of the 12 RCTs, five reported the operative duration, in all
Keywords: Laparoscopy-assisted colorectal surgery, Colorectal five reports, the operative duration was significantly longer
cancer, Open colorectal surgery, Randomized controlled trials.
for LAC than OC. Blood loss in patients who underwent
How to cite this article: Alhomoud H, Falcon OMT. LAC was significantly lower than that in patients who
Laparoscopic assisted vs Open Surgery for Colon Cancer. World underwent OC, by an average volume of 103.9 ml. There
J Lap Surg 2012;5(3):128-130.
was no significant difference in the number of transfused
Source of support: Nil
patients. The duration of hospital stay and the time of oral
Conflict of interest: None diet were significantly shorter with LAC than with OC. The
incision length was significantly shorter by 11.77 cm in LAC
INTRODUCTION than in OC. The rate of the overall postoperative
Colorectal cancer (CRC) is the fourth leading cause of complication was significantly lower in LAC than OC. The
cancer-specific mortality worldwide, with 610,000 related rate of ileus was significantly lower in LAC than OC. The
1
deaths each year. CRC is the fourth most common form of rate of anastomosis leakage between the two groups was
2
cancer in the United States and the third leading cause of insignificant. There were no significant differences in
3
cancer-related death in Western world. Because surgery perioperative mortality between the two groups.
remains the primary treatment modality in colorectal cancer,
the introduction of rapidly evolving laparoscopic techniques Long-term Outcomes
in the treatment of patients with colon and rectal cancer has With respect to overall recurrence, local recurrence, distal
been met with appropriate concern and resistance. metastasis and peritoneal dissemination, the differences
Laparoscopic resection for CRC was first described in between the two groups were insignificant. The analysis of
4
1991, and the enthusian for laparoscopic colectomy grew the wound site recurrence between LAC and OC groups
when recovery benefits for patients became more apparent. indicated no significant difference. There was also no
Numerous randomized controlled trials (RCT) comparing significant difference in the overall and cancer-related
laparoscopic to open surgery for colon cancer were mortality between the two groups.
published, clearly demonstrating that in experienced hands,
appropriate oncologic resection can be performed and DISCUSSION
5-8
produce results equivalent to the open techniques. The In short-term periods, laparoscopic surgery for colon cancer
aim of this paper is to review the published literature is associated with significantly longer operation times but
regarding the evolution of laparoscopic surgery for significantly less intraoperative blood loss compared with
colorectal cancer.
conventional open surgery. Patients who underwent LAC
resumed oral intake significantly earlier and had
MATERIALS AND METHODS
significantly shorter hospital stays than did patients who
Searched through the major medical database done, such underwent OC; this finding suggests that LAC leads to faster
as MEDLINE, EMBASE, Science Citation Index and recovery. The rate of postoperative complications was
Cochrane Controlled Trial the following search terms were significantly lower in LAC than in OC. The rate of ileus is
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