Hye Jin Kim, MD, Gyu-Seog Choi, MD, Jun-Seok Park, MD, Soo Yeun Park, MD, Soo Han Jun, MD. Departemt of surgery, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
AIMS: The laparoscopic approach has gained widespread clinical acceptance in the treatment of patients with colorectal cancer. However, whether or not a laparoscopic approach for colorectal cancer is safe and beneficial when combined with abdominal resection has not been established.
METHODS: Between March 1996 and April 2010 prospectively collected data were reviewed from 93 consecutive patients who had colorectal cancer and underwent simultaneous multiple organ resection (combined group) and 1,090 patients who underwent conventional laparoscopic right hemicolectomy and laparoscopic low/anterior resection for colorectal cancer (non-combined group). In the combined group, there were 9 gastric resections, 3 nephrectomies, 9 adrenalectomies, 56 cholecystectomies, and 21 gynecologic resections. In addition, five patients underwent simultaneous laparoscopic resection for three organs. The patient demographics, intra-operative outcomes, surgical morbidity, and short-term outcomes were compared in the two groups (the combined and non-combined groups).
RESULTS: There were no significant differences in the clinicopathologic variables between the two groups. The operating time was significantly longer in the combined groups (laparoscopic right hemicolectomy and laparoscopic low/anterior resection groups; p=0.048 and p<0.001, respectively) and the other intra-operative outcomes; the complications and open conversion rate were similar in the both groups. The rate of post-operative complications in the combined group (15.1%) was similar to the non-combined group (p=0.667). Oncologic safety for the colon and synchronous lesions were obtained in the combined group.
CONCLUSION: Simultaneous laparoscopic multiple organ resection combined with colorectal cancer is a safe and feasible option in select patients.
Program Number: P150