Single Centre Retrospective Control Study on Laparoscopic Versus Open Radical Rectectomy and Colectomy for Colorectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

FAN Ying , WU Shuodong , YU Hong , SU Yang , KONG Jing , TIAN Yu.

Department of The First Minimal-Invasive and Biliary Surgery， Shengjing Hospital， China Medical University， Shenyang 110004， China;

Corresponding author：

Keywords：

Colon cancer; Rectal cancer; Laparoscopy; Operation

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Objective To study the feasibility and curative effect of laparoscopic vs. open radical rectectomy and colectomy for colorectal cancer. Methods Sixty-two cases who underwent laparoscopic operation (17， 2， 10， 23， 9 and 1 case underwent radical right colectomy， radical transverse colectomy， radical left colectomy， Dixon， Miles and Hartmann operation respectively) and 78 cases who underwent open operation (17， 4， 11， 27， 18 and 1 case underwent radical right colectomy， radical transverse colectomy， radical left colectomy， Dixon， Miles and Hartmann operation respectively) in our department from Aug. 2001 to Jun. 2008 were included. The clinical data of patients in two groups were compared. Results There were no severe complications and death occurred in both groups and 4 cases in laparoscopic group were converted to open operation during the procedure. The mean operation time of laparoscopic group and open group were (230.6±23.5) min and (145.5±17.6) min respectively, there was a statistical difference between them (P＜0.01). The intra-operative blood loss of laparoscopic group was obviously less than that in open group 〔(135.5±22.5) ml vs. (300.6±34.5) ml， P＜0.01〕. There was no statistical difference of the number of cleared lymph nodes between two groups 〔(11.8±1.5) pieces vs. (13.3±1.7) pieces， P gt;0.05〕. The length of distal incision margin of rectal anterior resection in laparoscopic group was obviously longer than that in open group 〔(3.1±0.4) cm vs. (2.6±0.3) cm， P＜0.01〕. The gastrointestinal and urinary function of laparoscopic group recovered more quickly than those in open group 〔(2.3±0.7) d vs. (3.6±0.9) d for intake of liquid diet， P＜0.05； (3.5±1.1) d vs. (4.7±1.2) d for intake of solid diet， P＜0.05； (2.3±0.4) d vs. (4.4±1.2) d for duration of urethral catheterization， P＜0.01， respectively〕. The length of hospital stay in laparoscopic group was shorter than that in open group 〔(8.5±0.7) d vs. (12.8±0.9) d， P＜0.01〕. But the cost of hospitalization in laparoscopic group was higher than that in open group 〔(3.14±0.25)×104 yuan vs. (2.02±0.75)×104 yuan， P＜0.05〕. There was no statistical difference of the three-year survival rate between two groups (89.5% vs. 89.1%， P gt;0.05). Conclusion Laparoscopic radical rectectomy and colectomy for colorectal cancer is feasible and safe with minimal invasiveness.

Citation： FAN Ying,WU Shuodong,YU Hong,SU Yang,KONG Jing,TIAN Yu.. Single Centre Retrospective Control Study on Laparoscopic Versus Open Radical Rectectomy and Colectomy for Colorectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2009, 16(5): 384-388. doi: Copy

1.	Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [Ｊ]. Dis Colon Rectum, 2005; 48(12): 2217-2223.
2.	Mehta PP, Griffin J, Ganta S， et al. Laparoscopic-assisted colon resections: long-term results and survival [Ｊ]. JSLS, 2005; 9(2): 184-188.
3.	Gayet B, Cavaliere D, Castel B， et al. Laparoscopic liver surgery for metastases of colorectal cancer: analysis of a monocentric experience [Ｊ]. Suppl Tumori, 2005; 4(3): S135-S137.
4.	Reza MM, Blasco JA, Andradas E, et al. Systematic review of laparoscopic versus open surgery for colorectal cancer [Ｊ]. Br J Surg, 2006; 93(8): 921-928.
5.	郑民华, 马君俊. 腹腔镜外科在争议中发展 [Ｊ]. 中国普外基础与临床杂志， 2007； 14(5): 503-505.
6.	Veenhof AA, Engel AF, Craanen ME, et al. Laparoscopic versus open total mesorectal excision: a comparative study on short-term outcomes. A single-institution experience regarding anterior resections and abdominoperineal resections [Ｊ]. Dig Surg, 2007; 24(5): 367-374.
7.	Miyajima N, Fukunaga M, Hasegawa H, et al. Results of a multicenter study of 1057 cases of rectal cancer treated by laparoscopic surgery [Ｊ]. Surg Endosc, 2009; 23(1): 113-118.
8.	Franko J, Fassler SA, Rezvani M, et al. Conversion of laparoscopic colon resection does not affect survival in colon cancer [Ｊ]. Surg Endosc, 2008; 22(12): 2631-2634.
9.	Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial [Ｊ]. Lancet Oncol, 2005; 6(7): 477-484.
10.	Aziz O, Constantinides V, Tekkis PP， et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis [Ｊ]. Ann Surg Oncol, 2006; 13(3): 413-424.
11.	Abraham NS, Young JM, Solomon MJ. Metaanalysis of short-term outcomes after laparoscopic resection for colorectal cancer [Ｊ]. Br J Surg, 2004; 91(9): 1111-1124.
12.	Mirza MS, Longman RJ, Farrokhyar F， et al. Long-term outcomes for laparoscopic versus open resection of nonmetastatic colorectal cancer [Ｊ]. J Laparoendosc Adv Surg Tech A, 2008; 18(5): 679-685.
13.	Reymond MA, Wittekind C, Jung A, et al. The incidence of port-site metastases might be reduced [Ｊ]. Surg Endosc, 1997; 11(9): 902-906.
14.	Steinert R, Lippert H, Reymond MA. Tumor cell dissemination during laparoscopy: prevention and therapeutic opportunities [Ｊ]. Dig Surg, 2002; 19(6): 464-472.
15.	Jingli C, Rong C, Rubai X. Influence of colorectal laparoscopic surgery on dissemination and seeding of tumor cells [Ｊ]. Surg Endosc, 2006; 20(11): 1759-1761.
16.	Koopmann MC, Heise CP. Laparoscopic and minimally invasive resection of malignant colorectal disease[Ｊ]. Surg Clin North Am, 2008; 88(5): 1047-1072.
17.	Buchanan GN, Malik A, Parvaiz A， et al. Laparoscopic resection for colorectal cancer [Ｊ]. Br J Surg, 2008; 95(7): 893-902.
18.	King PM, Blazeby JM, Ewings P， et al. Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme [Ｊ]. Int J Colorectal Dis, 2008; 23(8): 795-800.
19.	Laurent C, Leblanc F, Bretagnol F, et al. Long-term wound advantages of the laparoscopic approach in rectal cancer [Ｊ]. Br J Surg, 2008; 95(7): 903-908.
20.	黄石川，游志坚，梁子君，等. 腹腔镜结直肠肿瘤手术18例报道 [Ｊ]. 中国普外基础与临床杂志， 2008； 15（10）：722-725.
21.	Park JS, Kang SB, Kim SW, et al. Economics and the laparoscopic surgery learning curve: comparison with open surgery for rectosigmoid cancer [Ｊ]. World J Surg, 2007; 31(9): 1827-1834.
22.	Choi YS, Lee SI, Lee TG, et al. Economic outcomes of laparoscopic versus open surgery for colorectal cancer in Korea [Ｊ]. Surg Today, 2007; 37(2): 127-132.
23.	Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial [Ｊ]. Lancet Oncol, 2009; 10(1): 44-52.
24.	Lacy AM, García-Valdecasas JC, Delgado S, et al. Laparoscopyassisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial [Ｊ]. Lancet, 2002; 359(9325): 2224-2229.
25.	Kuhry E, Schwenk W, Gaupset R, et al. Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials [Ｊ]. Cancer Treat Rev, 2008; 34(6): 498-504.
26.	Liang Y, Li G, Chen P, et al. Laparoscopic versus open colorectal resection for cancer: a meta-analysis of results of randomized controlled trials on recurrence [Ｊ]. Eur J Surg Oncol, 2008; 34(11): 1217-1224.
27.	Rosenberg J, Harvald T, Haglind E. Laparoscopic versus open total mesorectal excision for rectal cancer [Ｊ]. Ugeskr Laeger, 2007; 169(43): 3652-3655.
28.	Procacciante F, Flati D, Diamantini G, et al. Severe postoperative complications in colorectal surgery for cancer. Incidence related to the techniques employed: open versus laparoscopic colectomy [Ｊ]. Chir Ital, 2008; 60(3): 329-336.

1. Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [Ｊ]. Dis Colon Rectum, 2005; 48(12): 2217-2223.
2. Mehta PP, Griffin J, Ganta S， et al. Laparoscopic-assisted colon resections: long-term results and survival [Ｊ]. JSLS, 2005; 9(2): 184-188.
3. Gayet B, Cavaliere D, Castel B， et al. Laparoscopic liver surgery for metastases of colorectal cancer: analysis of a monocentric experience [Ｊ]. Suppl Tumori, 2005; 4(3): S135-S137.
4. Reza MM, Blasco JA, Andradas E, et al. Systematic review of laparoscopic versus open surgery for colorectal cancer [Ｊ]. Br J Surg, 2006; 93(8): 921-928.
5. 郑民华, 马君俊. 腹腔镜外科在争议中发展 [Ｊ]. 中国普外基础与临床杂志， 2007； 14(5): 503-505.
6. Veenhof AA, Engel AF, Craanen ME, et al. Laparoscopic versus open total mesorectal excision: a comparative study on short-term outcomes. A single-institution experience regarding anterior resections and abdominoperineal resections [Ｊ]. Dig Surg, 2007; 24(5): 367-374.
7. Miyajima N, Fukunaga M, Hasegawa H, et al. Results of a multicenter study of 1057 cases of rectal cancer treated by laparoscopic surgery [Ｊ]. Surg Endosc, 2009; 23(1): 113-118.
8. Franko J, Fassler SA, Rezvani M, et al. Conversion of laparoscopic colon resection does not affect survival in colon cancer [Ｊ]. Surg Endosc, 2008; 22(12): 2631-2634.
9. Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial [Ｊ]. Lancet Oncol, 2005; 6(7): 477-484.
10. Aziz O, Constantinides V, Tekkis PP， et al. Laparoscopic versus open surgery for rectal cancer: a meta-analysis [Ｊ]. Ann Surg Oncol, 2006; 13(3): 413-424.
11. Abraham NS, Young JM, Solomon MJ. Metaanalysis of short-term outcomes after laparoscopic resection for colorectal cancer [Ｊ]. Br J Surg, 2004; 91(9): 1111-1124.
12. Mirza MS, Longman RJ, Farrokhyar F， et al. Long-term outcomes for laparoscopic versus open resection of nonmetastatic colorectal cancer [Ｊ]. J Laparoendosc Adv Surg Tech A, 2008; 18(5): 679-685.
13. Reymond MA, Wittekind C, Jung A, et al. The incidence of port-site metastases might be reduced [Ｊ]. Surg Endosc, 1997; 11(9): 902-906.
14. Steinert R, Lippert H, Reymond MA. Tumor cell dissemination during laparoscopy: prevention and therapeutic opportunities [Ｊ]. Dig Surg, 2002; 19(6): 464-472.
15. Jingli C, Rong C, Rubai X. Influence of colorectal laparoscopic surgery on dissemination and seeding of tumor cells [Ｊ]. Surg Endosc, 2006; 20(11): 1759-1761.
16. Koopmann MC, Heise CP. Laparoscopic and minimally invasive resection of malignant colorectal disease[Ｊ]. Surg Clin North Am, 2008; 88(5): 1047-1072.
17. Buchanan GN, Malik A, Parvaiz A， et al. Laparoscopic resection for colorectal cancer [Ｊ]. Br J Surg, 2008; 95(7): 893-902.
18. King PM, Blazeby JM, Ewings P， et al. Detailed evaluation of functional recovery following laparoscopic or open surgery for colorectal cancer within an enhanced recovery programme [Ｊ]. Int J Colorectal Dis, 2008; 23(8): 795-800.
19. Laurent C, Leblanc F, Bretagnol F, et al. Long-term wound advantages of the laparoscopic approach in rectal cancer [Ｊ]. Br J Surg, 2008; 95(7): 903-908.
20. 黄石川，游志坚，梁子君，等. 腹腔镜结直肠肿瘤手术18例报道 [Ｊ]. 中国普外基础与临床杂志， 2008； 15（10）：722-725.
21. Park JS, Kang SB, Kim SW, et al. Economics and the laparoscopic surgery learning curve: comparison with open surgery for rectosigmoid cancer [Ｊ]. World J Surg, 2007; 31(9): 1827-1834.
22. Choi YS, Lee SI, Lee TG, et al. Economic outcomes of laparoscopic versus open surgery for colorectal cancer in Korea [Ｊ]. Surg Today, 2007; 37(2): 127-132.
23. Colon Cancer Laparoscopic or Open Resection Study Group, Buunen M, Veldkamp R, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial [Ｊ]. Lancet Oncol, 2009; 10(1): 44-52.
24. Lacy AM, García-Valdecasas JC, Delgado S, et al. Laparoscopyassisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial [Ｊ]. Lancet, 2002; 359(9325): 2224-2229.
25. Kuhry E, Schwenk W, Gaupset R, et al. Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials [Ｊ]. Cancer Treat Rev, 2008; 34(6): 498-504.
26. Liang Y, Li G, Chen P, et al. Laparoscopic versus open colorectal resection for cancer: a meta-analysis of results of randomized controlled trials on recurrence [Ｊ]. Eur J Surg Oncol, 2008; 34(11): 1217-1224.
27. Rosenberg J, Harvald T, Haglind E. Laparoscopic versus open total mesorectal excision for rectal cancer [Ｊ]. Ugeskr Laeger, 2007; 169(43): 3652-3655.
28. Procacciante F, Flati D, Diamantini G, et al. Severe postoperative complications in colorectal surgery for cancer. Incidence related to the techniques employed: open versus laparoscopic colectomy [Ｊ]. Chir Ital, 2008; 60(3): 329-336.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Single Centre Retrospective Control Study on Laparoscopic Versus Open Radical Rectectomy and Colectomy for Colorectal Cancer

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