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. 2019 Jun 19;8(6):875.
doi: 10.3390/jcm8060875.

Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution

Chong-Chi Chiu  1   2   3 , Wen-Li Lin  4 , Hon-Yi Shi  5   6   7 , Chien-Cheng Huang  8   9 , Jyh-Jou Chen  10 , Shih-Bin Su  11   12   13 , Chih-Cheng Lai  14 , Chien-Ming Chao  15 , Chao-Jung Tsao  16 , Shang-Hung Chen  17 , Jhi-Joung Wang  18   19
Affiliations

Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution

Chong-Chi Chiu et al. J Clin Med. .

Abstract

The oncologic merits of the laparoscopic technique for colorectal cancer surgery remain debatable. Eligible patients with non-metastatic colorectal cancer who were scheduled for an elective resection by one surgeon in a medical institution were randomized to either laparoscopic or open surgery. During this period, a total of 188 patients received laparoscopic surgery and the other 163 patients received the open approach. The primary endpoint was cancer-free five-year survival after operative treatment, and the secondary endpoint was the tumor recurrence incidence. Besides, surgical complications were also compared. There was no statistically significant difference between open and laparoscopic groups regarding the average number of lymph nodes dissected, ileus, anastomosis leakage, overall mortality rate, cancer recurrence rate, or cancer-free five-year survival. Even though performing a laparoscopic approach used a significantly longer operation time, this technique was more effective for colorectal cancer treatment in terms of shorter hospital stay and less blood loss. Meanwhile, fewer patients receiving the laparoscopic approach developed postoperative urinary tract infection, wound infection, or pneumonia, which reached statistical significance. For non-metastatic colorectal cancer patients, laparoscopic surgery resulted in better short-term outcomes, whether in several surgical complications and intra-operative blood loss. Though there was no significant statistical difference in terms of cancer-free five-year survival and tumor recurrence, it is strongly recommended that patients undergo laparoscopic surgery if not contraindicated.

Keywords: laparoscopic; non-metastatic colorectal cancer; oncologic outcome; open surgery; single surgeon experience; surgical complication.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The flowchart of the study design.
Figure 2
Figure 2
(A) Kaplan–Meier curve of cancer-free five-year survival in stage I patients (p = 0.206); (B) Kaplan–Meier curve of cancer-free five-year survival in stage II patients (p = 0.713); (C) Kaplan–Meier curve of cancer-free five-year survival in stage III patients (p = 0.426); (D) Kaplan–Meier curve of cancer-free five-year survival in all stage patients (p = 0.328).
Figure 2
Figure 2
(A) Kaplan–Meier curve of cancer-free five-year survival in stage I patients (p = 0.206); (B) Kaplan–Meier curve of cancer-free five-year survival in stage II patients (p = 0.713); (C) Kaplan–Meier curve of cancer-free five-year survival in stage III patients (p = 0.426); (D) Kaplan–Meier curve of cancer-free five-year survival in all stage patients (p = 0.328).
Figure 3
Figure 3
Cumulative incidence curve of tumor recurrence in all stage patients (p = 0.186).
See this image and copyright information in PMC

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