Prospective comparison of open vs. laparoscopic colon surgery for carcinoma: Five-year results

Morris E. Franklin, Daniel Rosenthal, Daniel Abrego-Medina, James P. Dorman, Jeffrey L. Glass, Richard Norem, Antonio Diaz

Research output: Contribution to journalArticlepeer-review

426 Scopus citations

Abstract

Laparoscopy for colonic diseases began in 1990 and has established a role in benign disease. Early observations and experiences demonstrated feasibility of laparoscopic surgery for a variety of colonic disease processes, but the applicability to colonic carcinoma was unclear. METHODS: In 1990, we began a comparative study of open (OCR) vs. laparoscopic (LCR) approach to colon cancer. The study progressed 65 months, with 224 patients in OCR group and 191 patients in LCR group. Parameters studied are stage, location, length of specimen, number of lymph nodes resected, margins, postoperative course, wound complications, recurrence rates, and immediate and long-term survival. OCR were standardized by one group, and LCR were standardized by a second group. All patients undergoing LCR were given freedom to choose either OCR or LCR, and informed consent was obtained. RESULTS: Equal or greater lymph node retrieval, resections, and distal margins were evident with LCR. Benefits with LCR were shown with shorter hospitalization (5.7 vs. 9.7 days), less blood loss, less wound problems (1 vs. 14), and quicker return of bowel function. Survival, recurrence, and death rates were essentially the same. There were no trocar implants in the LCR group. CONCLUSION: After five years, this study shows that laparoscopy does no harm to the patient, offers comparable oncologic resections, and seems to be patient-friendly, with less pain, quicker return of bowel functions, shortened hospitalization, and quicker return to full activity.

Original languageEnglish (US)
Pages (from-to)S35-S46
JournalDiseases of the Colon and Rectum
Volume39
Issue number10 SUPPL.
DOIs
StatePublished - 1996
Externally publishedYes

Keywords

  • Colon cancer
  • Colon surgery
  • Laparoscopic colon resections for cancer
  • Laparoscopy
  • Outcomes of laparoscopic colon surgery

ASJC Scopus subject areas

  • Gastroenterology

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