Akiyo Matsumoto, MD, Kaida Arita, MD, Tetsuya Tajima, MD, Tomohiro Narita, MD, Masashi Okuda, MD, Hisashi Fujiwara, MD, Masaki Tashiro, MD, Shigeo Haruki, MD, Shinsuke Usui, MD, Kouji Ito, MD, Noriaki Takiguchi, MD, Susumu Hiranuma, MD, Katsuhiro Sanada, MD
Tsuchiura Kyodo General Hospital
Purpose : The aim of this study was to compare the long-term out come of laparoscopic-assisted colectomy (LAC) and open colectomy (OC) for nonmetastatic colon cancer.
Materials and Methods : From January 2003 to December 2011 all patients with adenocarcinoma of the colon were assessed for entry. Adjuvant chemotherapy and postoperative follow-up were similar in both groups. Primary end point was disease free survival and secondary end points were overall survival, complications, variables related to recovery and the quality of life.
Results : Five hundred and thirty-nine patients entered the study (299 LAC group and 240 OC group). There was a tendency of higher overall survival (St 0 : p = 0.0567, NS. St 2A : p = 0.1971, NS. St 2B : p = 0.2982, NS. St 3A : p = 0.6171, NS. St 3B : p = 0.3243, NS. St 3C : p = 0.8873, NS. )for the LAC group. There was a tendency of higher disease free survival (St 0 : p = 0.0567, NS. St 2A : p = 0.0968, NS. St 2B : p = 0.2863, NS. St 3A : p = 0.1267, NS. St 3C : p = 0.5572, NS.) in the LAC group. Overall survival was higher (St 1 : p = 0.0012) in the LAC group. Disease free survival was higher (St 1 : p = 0.0012. St 2 : p = 0.0478. St 3B : p = 0.0498. St 3 : p = 0.0108) in the LAC group when compared with OC group. Blood loss was lower (p = <0.0001), fluid intake was faster (p = <0.0001), hospital stay was shorter (p = 0.0003) in the LAC group. The occurrence rates of bowel obstraction, wound infection and abdominal wall hernia were lower (p = <0.0001) in the LAC group. There were no differences in the reoperation rate (p = 0.1976, NS) or 30-day mortality (p = 0.1138, NS).
Conclusions : LAC is more effective than OC in the treatment of colon cancer.
Session: Podium Presentation
Program Number: S069