Laparoscopic resections in colorectal cancers-short term and medium-term outcome with 2 years follow up

Authors

  • Vinay Kumar K. Department of Gastrointestinal Surgery, Medical Trust Hospital, Ernakulam, Kerala, India
  • Deepak Varma Department of Gastrointestinal Surgery, Medical Trust Hospital, Ernakulam, Kerala, India
  • Rahul D. Kunju Department of General Surgery, Believers Church Medical College Hospital, Thiruvalla, Kerala, India
  • Sujith Philip Believers Church Regional Institute of Gastroenterology Hepatology and Transplantation, Believers Church Medical College Hospital, Thiruvalla, Kerala, India

DOI:

https://doi.org/10.18203/2349-2902.isj20230966

Keywords:

Laparoscopic surgery, CRC

Abstract

Background: After decades of debate and controversy, the short-term benefits and at least equivalent long-term outcomes of laparoscopic colon surgery compared to open surgery has now been well established.

Methods: In this article, short- and medium -term outcomes of patients undergoing laparoscopic colorectal surgery for cancer in a tertiary care hospital is analysed. A retrospective analysis of prospectively collected data of all patients who had laparoscopic management of colorectal cancer (CRC) for 3 years was done. Patients were followed up for 2 years after treatment. The prospectively collected data was analysed to find out the incidence of complications, local or distant metastases and the survival rates.

Results: There were 65 patients who underwent laparoscopic surgery among 120 patients who had treatment for colorectal carcinoma in the study period. The 26 patients underwent low anterior resection followed by 14 patients   and 13 patients undergoing left colonic and right colonic resections respectively. While abdominoperineal resection was carried out in 6 patients, 3 each patients were treated by ultra-low anterior resection and subtotal colectomy. Morbidities of varying grade according to Clavien Dindo classification was less for laparoscopic surgery. Recurrence occurred in 14.8% at 2 years follow up. The 2-year survival rate was noted to be 87.7%   among the study group who underwent laparoscopic surgery.

Conclusions: Judicious selection of patients and the appropriate selection of technique help to achieve good short-and long-term results without compromising on oncological outcome in laparoscopic surgeries for colorectal malignancies.

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References

Ferlay J, Shin H, Bray F, Forman D, Mathers C, Parkin D. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893-917.

Lacy A. Colon cancer: laparoscopic resection. Ann Oncol. 2005;16(2):ii88-92.

Choy I, Kitto S, Adu-Aryee N, Okrainec A. Barriers to the uptake of laparoscopic surgery in a lower-middle-income country. Surg Endoscopy. 2013;27(11):4009-15.

Baigrie R, Stupart D. Introduction of laparoscopic colorectal cancer surgery in developing nations. Bri J Surg. 2010;97(5):625-7.

Khan M, Pishori T, Tayeb M, Ali R. Laparoscopic appendectomy for acute appendicitis: Is this a feasible option for developing countries? Saudi J Gastroenterol. 2010;16(1):25.

Bal S. Feasibility and safety of day care laparoscopic cholecystectomy in a developing country. Postgraduate Med J. 2003;79(931):284-8.

Clinical Outcomes of Surgical Therapy Study Group, Nelson H, Sargent DJ, Wieand HS, Fleshman J, Anvari M et al. A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer. N Eng J Med. 2004;350(20):2050-9.

Hasegawa H, Kabeshima Y, Watanabe M, Yamamoto S, Kitajima M. Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer. Surg Endosc. 2003;17(4):636-40.

Munasinghe A, Singh B, Mahmoud N, Joy M, Chang DC, Penninckx F et al. Reduced perioperative death following laparoscopic colorectal resection: results of an international observational study. Surg Endosc 2015;16(1):25.

Kennedy R, Francis E, Wharton R, Blazeby J, Quirke P, West N et al. Multicenter Randomized Controlled Trial of Conventional Versus Laparoscopic Surgery for Colorectal Cancer Within an Enhanced Recovery Programme: EnROL. J Clin Oncol. 2014;32(17):1804-11.

Law W, Lee Y, Choi H, Seto C, Ho J. Impact of Laparoscopic Resection for Colorectal Cancer on Operative Outcomes and Survival. Ann Surg. 2007;245(1):1-7.

Bonjer H, Deijen C, Abis G, Cuesta M, Van der Pas M, de Lange-de Klerk E et al. A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer. N Eng J Med. 2015;372(14):1324-32.

Pędziwiatr M, Pisarska M, Kisielewski M, Major P, Mydlowska A, Rubinkiewicz M et al. ERAS protocol in laparoscopic surgery for colonic versus rectal carcinoma: are there differences in short-term outcomes? Med Oncol. 2016;33(6):56.

Prakash K, Varma D, Rajan M, Kamlesh N, Zacharias P, Ganesh Narayanan R et al. Laparoscopic Colonic Resection for Rectosigmoid Colonic Tumours: A Retrospective Analysis and Comparison with Open Resection. Ind J Surg. 2010;72(4):318-22.

Lindsey I, George B, Mortensen N. Lessons from laparoscopic surgery-a fresh look at post-operative management after major colorectal procedures. Colorect Dis. 2001;3(2):107-14.

Guillou P, Quirke P, Thorpe H, Walker J, Jayne D, Smith A et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet. 2005;365(9472):1718-26.

Hughes ES, McDermott FT, Polglase AL, Johnson WR. Tumor recurrence in the abdominal wall scar tissue after large-bowel cancer surgery. Dis Colon Rectum.1983;26(9):571-2.

Kang J, Choi G, Oh J, Kim N, Park J, Kim M et al. Multicenter Analysis of Long-Term Oncologic Impact of Anastomotic Leakage After Laparoscopic Total Mesorectal Excision. Medicine. 2015;94(29):e1202.

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205-13.

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Published

2023-03-31

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Original Research Articles