Soo Yeun Park. Surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
Background The laparoscopic salvage surgery for colorectal cancer is a novel, but has been a technically challenging option for surgeons. The aim of this study is to evaluate the feasibility, safety and short term outcomes in recurrent and metachronous colorectal cancer patients treated by laparoscopic surgery and to compare operative results with standard open approach.
Methods From January 1996 to February 2010, data for this study came from the prospectively collected databases. The data of patients, operations and short term outcomes were analyzed and compared between open and laparoscopic salvage group.
Results In the 3425 patients studied, colorectal cancer (CRC) recurred in 565 patients (16.5%) and 41 patients had colorectal savage operations. Among them, 26 patients underwent open surgery (RO) and 15 cases underwent laparoscopic surgery (RL). Operation time (p=0.059) and length of stay (p=0.059) were not significant but the morbidity (p=0.035) was significantly different in the recurrent laparoscopic group. Short term disease-free intervals and overall survivals of recurrent patients were not significantly different from the open patients. The metachronous CRC occurred in 13 patients (0.38%) and 5 had the open (MO) and 6 had the laparoscopic (ML) salvage. There was significant difference in operation time (p=0.045) in the metachronous laparoscopic group. Late in the study, 4 patients in the recurrent laparoscopic group and 1 patient in the metachronous group were converted to the open surgery.
Conclusion Laparoscopic surgery showed favorable short-term outcomes in both recurrent and metachronous CRC. Thus minimally invasive salvage approaches should be considered as a treatment option for the recurrent and the metachronous colorectal cancer patients
Key words: laparoscopy • salvage surgery • colorectal cancer • recurrence • metachronous
Program Number: P160