Oncologic outcome of laparoscopic versus open surgery for advanced colorectal cancer

Abstract

Background/aims: Laparoscopic colorectal surgery for advanced colorectal carcinoma still remains controversial because of the technical difficulties in lymph node dissection, which is a routine procedure for advanced colorectal carcinoma, and uncertainty regarding the oncologic outcome after laparoscopic colectomy. This study reviewed the results of laparoscopic colectomy with lymph node dissection in patients with advanced colorectal carcinoma performed at our hospital.

Methodology: The oncologic outcomes of 48 patients with advanced colorectal carcinoma who underwent laparoscopic colectomy between 1993 and 1998 were compared with those of 48 matched patients who underwent conventional open surgery during the same period or immediately before the introduction of laparoscopic surgery.

Results: The median follow-up for the laparoscopic group and the open colectomy group was 41 and 68 months, respectively. No port site recurrence occurred in the laparoscopic group, and the medium-term disease-free rate, overall survival rate, as well as the patterns of recurrence were comparable in the two groups.

Conclusions: Oncologic outcome of laparoscopic colectomy at a minimum of two years was not compromised compared with conventional open surgery even in advanced carcinoma. However, information regarding true oncologic outcome will require careful long-term follow-up.