Introduction: Laparoscopic surgery was introduced for the treatment of colorectal cancer about 15 years ago in Japan and now has been rapidly widespread. The objective of this study was to demonstrate the safety and feasibility of laparoscopy-assisted surgery for colorectal cancer in aspects of treatment results and expenses as compared to open surgery.
Patients and Methods: Laparoscopic surgery for colorectal cancer was introduced in July 2005 in Cancer Institute Hospital in Japan. Between then and December 2006, we have experienced 272 laparoscopic colectomy (LAC) and 208 open colectomy (OC). Patients with complete obstruction caused by the cancer, cancer extensively invading adjacent organs, lymph node metastasis at the root of the tumor-supplying artery, and bulky cancer larger than 7-cm-diameter in size were excluded for LAC.
Results: The conversion to open surgery was found in one case (0.3%). There were no postoperative death in LAC and one in OC (0.5%). LAC had longer operation time (195 min. vs. 171 min.), less blood loss (10 ml vs. 65 ml) and shorter postoperative hospital stay (9 days vs. 13 days) compared to OC. Total postoperative morbidity rate was lower in LAC than OC (8.8% vs. 17.3%). The rate of anastomotic leak was slightly higher in LAC (1.5% vs. 0.5%). Wound infection and persistent ileus were significantly lower in LAC (4.0% vs. 10.0%, 0.7% vs. 6.3%, respectively). In addition, surgeonsf experience did not influence surgical results of LAC under the supervision of a well-experienced surgeon. Concerning the costs, total medical expense was higher in OC, and total expense/postoperative stay was higher in LAC due to shorter hospital stay after surgery. It would be considered that LAC provides decent treatment expenses on both patients and hospital.
Conclusion: The present study demonstrated that laparoscopic colectomy is safe and effective in both aspects of treatment results and expenses. It is our future task to continue the study and demonstrate the long-term outcome of LAC.
Program Number: P105