Comparison study of laparoscopic (LAP) surgery vs. open surgery (OS) for descending colon cancer

doi:10.3877/cma.j.issn.2095-3224.2017.05.005

Abstract

Abstract:

Objective

To evaluate short-time outcomes of laparoscopic surgery and open surgery (OS) for left-sided colon cancer.

Methods

Clinical data of 144 patients who received LAP or OS left hemicolectomy in Chinese Academy of Medical Science and Peking Union Medical College from January 2010 to March 2016 were collected and analyzed. These patients were divided into LAP group (n=66) and OS group (n=78). The operation time, intraoperative blood loss, the number of dissected lymph nodes and short-time outcomes were compared between two groups.

Results

There was a significant difference in operating time between the LAP group (151.36±26.98) min and the OS group (190.30±15.30) min (t=-5.130, P=0.0014). There was no significant difference in intraoperative blood loss between the LAP group (75±29.92) ml and the OS group (76.87±24.59) ml (t=-0.836, P=0.4613). There was a significant difference in length of surgical incision between the LAP group (6.88±3.00) cm and the OS group (15.57±2.22) cm (t=-28.484, P<0.001).There was no significant difference in number of swollen lymph nodes between the LAP group (21.58±8.57) and the OS group (23.82±10.96) (t=-0.283, P=0.2670). The average postoperative evacuation time (P=0.0015), getting out-of-bed time (P=0.0009), time to eat food (P=0.0018) were shorter in LAP group than in OS group.The hospital stays were shorter in LAP group than in OS group (t=-3.762, P=0.0364). there was no statistically significant difference between the two groups in postoperative complications (P=0.333).

Conclusions

LAP for left sided colon cancer is safe and reliable. Compared to the OS group, LAP has advantages including less surgery time, smaller surgical incision, faster recovery and shorter hospital stays.

Key words: Colorectal neoplasms, Laparoscopes, Surgical procedures, minimally invasive, Laparotomy

Jinhua Tao, Qian Liu, Zheng Liu, Wei Pei, Zheng Jiang, Chunguang Guo, Jianan Chen, Yafei Leng. Comparison study of laparoscopic (LAP) surgery vs. open surgery (OS) for descending colon cancer[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2017, 06(05): 377-380.

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References 17

[1]	Trebuche G, Lechaux D, Lecalve JL . Laparoscopic rectal excision for cancer using total mesorectaol excision (TME). Long term outcome of a series of 179 patients[J]. Surg Endosc, 2002, 16(4):18-21.
[2]	Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer : short-term outcomes of a randomised trial[J]. Lancet Oncol, 2005, 6(7):477-484.
[3]	Bai HL, Chen B, Zhou Y, et al. Five-year long-term outcomes of laparoscopic surgery for colon cancer[J]. World J Gastroenterol, 2010, 16(39):4992-4997.
[4]	Inomata M, Yasuda K, Shiraishi N, et al.Clinical evidences of laparoscopic versus open surgery for colorectal cancer[J]. Jpn J Clin Oncol, 2009, 39(8):471-477.
[5]	Lezoche E, Feliciotti F, Paganini A M, et al.Laproscopic vs open hemicolectomy for colon cancer[J]. Surg Endosc, 2002, 16(4):596-602.
[6]	Jennifer L Agnew, Benjamin Abbadessa, I Michael Leitman, et al.Obstructing malignant lesions of the colon[J]. Surg Clin North Am, 1986, 66(4):807-820.
[7]	郑民华，马君俊，陆爱国, 等. 腹腔镜左半结肠癌根治手术的技巧与短期疗效[J]. 中华消化外科杂志, 2007, 6(3):171-174.
[8]	Lezoche E, Feliciotti F, Paganini AM, et al. Laparoscopic VS open hemicolectomy for colon cancer[J]. Surg Endosc, 2002, 16(4):596-602.
[9]	Liang JT, Huang KC, Lai HS, et al. Oncologic results of laparoscopic versus conventional open surgery for stage II or Ⅲ left-sided colon cancers: a randomized controlled trial[J]. Ann Surg Oncol, 2007, 14(1):109-117.
[10]	Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy)[J]. Surg Laparosc Endosc, 1991, 1(3):144-150.
[11]	Tekkis PP, Senagore AJ, Delaney CP, et a1. A Comparison of Laparoscopically Assisted and Open Colectomy for Colon Cancer[J]. Engl J Med, 2004, 350(20):2050-2059.
[12]	Van der Pas MH, Haglind E, Cuesta MA, et a1. Laparoscopic versus open surgery for rectal cancer (COLOR II) short-term outcomes of a randomised phase 3 trial[J]. Lancet Oncol, 2013, 14(3):210-218.
[13]	Bonjer HJ, Deijen CL, Haglind E, et al. A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer[J]. N Engl J Med, 2015, 373(2):194.
[14]	Mehta PP, Griffin J, Ganta S, et al.Laparoscopic-assisted colon resections: long-term results and survival[J]. JSLS, 2005, 9(2):184-188.
[15]	Veldkamp R, Kuhry E, Hop WC, et al. Colon cancer laparoscopic or open resection studygroup(COLOR). L paroscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial[J]. Lancet Onco1, 2005, 6(7):477-484.
[16]	Siani LM, Ferranti F, Marzano M, et al. Five-year oncological results of laparoscopic versus open left hemicolectomy[J]. Chir Ital, 2009, 61(5-6):579-583.
[17]	Han KS, Choi GS, Park JS, et al. Short-term Outcomes of a Laparoscopic Left Hemicolectomy for Descending Colon Cancer:Retrospective Comparison with an Open Left Hemicolectomy[J]. J Korean Soc Coloproctol, 2010, 26(5):347-352.

组别		LAP组	OS组	t/Χ²值	P值
例数		78	66
性别（例）				0.004	0.952
	男	54	46
	女	24	20
年龄（岁，±s）		55.00±11.05	56.54±8.24	-0.012	0.6188
肿瘤大小（cm，±s）		3.00±1.40	3.40±2.10	-0.383	0.6210
肿瘤距肛位置（cm，±s）		42.30±3.10	45.10±1.60	-2.496	0.8320
病理类型（例）					1.0000
	腺癌	77	66
	粘液腺癌	1	0
分期(例)				0.279	0.7318
	Ⅰ	8	4
	Ⅱ	28	24
	Ⅲ	42	38

组别		LAP组	OS组	t/Χ²值	P值
例数		78	66
性别（例）				0.004	0.952
	男	54	46
	女	24	20
年龄（岁，±s）		55.00±11.05	56.54±8.24	-0.012	0.6188
肿瘤大小（cm，±s）		3.00±1.40	3.40±2.10	-0.383	0.6210
肿瘤距肛位置（cm，±s）		42.30±3.10	45.10±1.60	-2.496	0.8320
病理类型（例）					1.0000
	腺癌	77	66
	粘液腺癌	1	0
分期(例)				0.279	0.7318
	Ⅰ	8	4
	Ⅱ	28	24
	Ⅲ	42	38

参数	LAP（n=78）	OS（n=66）	t值	P值
手术时间（min）	151.36±26.98	190.30±15.30	-5.130	0.0014
出血量（ml）	75±24.59	76.87±29.92	-0.836	0.4613
手术切口（cm）	6.88±3.00	15.57±2.22	-28.484	0.0000
清扫淋巴结总数（个）	21.58±8.57	23.82±10.96	-0.283	0.2670
阳性淋巴结数（个）	1.79±2.85	1.31±1.22	1.315	0.3370
术后排气时间（h）	77.41±19.36	131.52±20.47	-44.561	0.0015
术后下床时间（h）	84.23±21.18	140.26±18.70	-41.473	0.009
术后进食时间（h）	97.23±20.43	151.88±24.50	-48.331	0.0018
住院天数（d）	14.19±4.80	17.21±2.38	-3.762	0.0364

参数	LAP（n=78）	OS（n=66）	t值	P值
手术时间（min）	151.36±26.98	190.30±15.30	-5.130	0.0014
出血量（ml）	75±24.59	76.87±29.92	-0.836	0.4613
手术切口（cm）	6.88±3.00	15.57±2.22	-28.484	0.0000
清扫淋巴结总数（个）	21.58±8.57	23.82±10.96	-0.283	0.2670
阳性淋巴结数（个）	1.79±2.85	1.31±1.22	1.315	0.3370
术后排气时间（h）	77.41±19.36	131.52±20.47	-44.561	0.0015
术后下床时间（h）	84.23±21.18	140.26±18.70	-41.473	0.009
术后进食时间（h）	97.23±20.43	151.88±24.50	-48.331	0.0018
住院天数（d）	14.19±4.80	17.21±2.38	-3.762	0.0364

项目	LAP组（78）	OS组（66）	P值
手术并发症（例）	1	3	0.333
肠梗阻	1	2
切口感染	0	1

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