Original Article

J Minim Invasive Surg 2012; 15(4): 133-137

Published online December 15, 2012

https://doi.org/10.7602/jmis.2012.15.4.133

© The Korean Society of Endo-Laparoscopic & Robotic Surgery

결장암 환자의 개복 결장 절제술 및 복강경 결장 절제술에 대한 단일 기관 내 비교 연구

공경환ㆍ김일동ㆍ김기호ㆍ박진수ㆍ서병선ㆍ김상욱ㆍ임혜인

대진의료재단 분당제생병원 외과

Single-center Comparative Study of Laparoscopic Versus Open Colon Surgery

Kyoung Hwan Kong, M.D., Il Dong Kim, M.D., Ki Ho Kim, M.D., Jin Soo Park, M.D., Byung Sun Suh, M.D., Sang Wook Kim, M.D., Hye In Lim, M.D.

Department of Surgery, Dae Jin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Purpose: To examine the change in practice from open to laparoscopic practice in our local trust and compare the benefits with those of an open surgery group.
Methods: This retrospective comprehensive review analyzed 225 patients who underwent resection of colon cancers at the Dae Jin Medical Center, including 182 who underwent laparoscopic surgery (LAC) and 43 who underwent conventional open surgery (OC), conducted by a single surgeon from August 2002 to August 2010. The LAC group was divided into two groups, 50 patients during the early period and 132 patients during the late period, and short-term and oncologic outcomes were recorded. Patients identified through clinical coding and data were analyzed using the Statistical Package for Social Sciences, version 18.0 (2009. SPSS Inc. USA).
Results: Comparisons of 43 open versus 50 early and 132 late laparoscopic colon surgeries for various indications and outcomes were made. The operative time was longer in the LAC group (early and late LAC group) than in the OC group. However, post operative recovery time (hospital stay, days to sips of water and days to soft diet) was significantly shorter in the early and late LAC group than in the OC group. There was no significant difference between the LAC groups and open group with respect to age, sex, American Society of Anesthesiologists, tumor-node stage, morbidity, mortality, overall survival rates, disease free survival rates and recurrence rates.
Conclusion: In our experience, laparoscopic surgery resulted in acceptable short term outcomes and our results support those of other studies with respect to clinical outcomes of laparoscopic surgery.

Keywords Laparoscopic, Open, Colectomy, Colon cancer

  1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991;1:144-150.
    Pubmed
  2. Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopic assisted colectomy vs. ope n colectomy for treatment of non-metastatic colon cancer: a r andomized trial. Lancet 2002;359:2224-2229.
    CrossRef
  3. Khalili TM, Fleshner PR, Hiatt JR, et al. Comparison of laparoscopic with open approaches. Dis Colon Rectum 1998;41:832-838.
    Pubmed CrossRef
  4. Nelson H, Sargent DJ, Wieand HS, et al. for the Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. New Engl J Med 2004;350:2050-2059.
    Pubmed CrossRef
  5. Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patient s with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 2005;365:1718-1726.
    CrossRef
  6. Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 2005;6:477-484.
    CrossRef
  7. Kim JH, Hur JM, Yoon SS, Kim SW, Shim MC, Kwun KB. Is laparoscopic procedure adequate for colorectal cancer surgery?. J Korean Soc Coloproctol 1999;15:434-442.
  8. Bennett CL, Stryker SJ, Ferreira MR, Adams J, Beart RW. The learning curve for laparoscopic colorectal surgery. Preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomi es. Arch Surg 1997;132:41-44.
    Pubmed CrossRef
  9. Joh YG, Kim SH, Yoon JS, Chung CS, Lee DK. Impact of body mass index on surgical outcomes of laparoscopic colorectal cancer resection. J Korean Soc Coloproctol 2003;19:243-247.
  10. Joh YG, Kim SH, Yoon JS, Cha YJ, Chung CS, Lee DK. An experience of laparoscopic resection for colorectal cancer in patients with previous abdominal surgery. J Korean Soc Coloproctol 2002;5:160-164.
  11. Kim SH, Milsom JW. Is laparo scopic technique oncologically appropriate for colorectal cancer surgery? J Korean Med Sci 1998;13:227-233.
    Pubmed KoreaMed CrossRef
  12. Goldstein NS. Lymph node recoveries from 2427 pT3 colorectal resection specimens spanning 45 years: recommendation for a minimum number of lymph nodes based on predictive probabilities. Am J Surg Pathol 2002;26:179-189.
    Pubmed CrossRef
  13. Goldstein NS, Sanford W, Coffey M, Layfield LJ. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered. Am J Clin Pathol 1996;106:209-216.
    Pubmed CrossRef
  14. Schlachata CM, Mamazza J, Seshadri PA, et al. Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 2001;44:217-222.
    CrossRef
  15. Tekkis PP, Senagore AJ, Delaney CP, Fazio VW. Evaluation of the learning curve in laparoscopic colorectal surgery:comparison of right-sided and le ft-sided resections. Ann Surg 2005;242:83-91.
    Pubmed KoreaMed CrossRef

Article

Original Article

J Minim Invasive Surg 2012; 15(4): 133-137

Published online December 15, 2012 https://doi.org/10.7602/jmis.2012.15.4.133

Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.

결장암 환자의 개복 결장 절제술 및 복강경 결장 절제술에 대한 단일 기관 내 비교 연구

공경환ㆍ김일동ㆍ김기호ㆍ박진수ㆍ서병선ㆍ김상욱ㆍ임혜인

대진의료재단 분당제생병원 외과

Single-center Comparative Study of Laparoscopic Versus Open Colon Surgery

Kyoung Hwan Kong, M.D., Il Dong Kim, M.D., Ki Ho Kim, M.D., Jin Soo Park, M.D., Byung Sun Suh, M.D., Sang Wook Kim, M.D., Hye In Lim, M.D.

Department of Surgery, Dae Jin Medical Center, Bundang Jesaeng General Hospital, Seongnam, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose: To examine the change in practice from open to laparoscopic practice in our local trust and compare the benefits with those of an open surgery group.
Methods: This retrospective comprehensive review analyzed 225 patients who underwent resection of colon cancers at the Dae Jin Medical Center, including 182 who underwent laparoscopic surgery (LAC) and 43 who underwent conventional open surgery (OC), conducted by a single surgeon from August 2002 to August 2010. The LAC group was divided into two groups, 50 patients during the early period and 132 patients during the late period, and short-term and oncologic outcomes were recorded. Patients identified through clinical coding and data were analyzed using the Statistical Package for Social Sciences, version 18.0 (2009. SPSS Inc. USA).
Results: Comparisons of 43 open versus 50 early and 132 late laparoscopic colon surgeries for various indications and outcomes were made. The operative time was longer in the LAC group (early and late LAC group) than in the OC group. However, post operative recovery time (hospital stay, days to sips of water and days to soft diet) was significantly shorter in the early and late LAC group than in the OC group. There was no significant difference between the LAC groups and open group with respect to age, sex, American Society of Anesthesiologists, tumor-node stage, morbidity, mortality, overall survival rates, disease free survival rates and recurrence rates.
Conclusion: In our experience, laparoscopic surgery resulted in acceptable short term outcomes and our results support those of other studies with respect to clinical outcomes of laparoscopic surgery.

Keywords: Laparoscopic, Open, Colectomy, Colon cancer

References

  1. Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991;1:144-150.
    Pubmed
  2. Lacy AM, Garcia-Valdecasas JC, Delgado S, et al. Laparoscopic assisted colectomy vs. ope n colectomy for treatment of non-metastatic colon cancer: a r andomized trial. Lancet 2002;359:2224-2229.
    CrossRef
  3. Khalili TM, Fleshner PR, Hiatt JR, et al. Comparison of laparoscopic with open approaches. Dis Colon Rectum 1998;41:832-838.
    Pubmed CrossRef
  4. Nelson H, Sargent DJ, Wieand HS, et al. for the Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. New Engl J Med 2004;350:2050-2059.
    Pubmed CrossRef
  5. Guillou PJ, Quirke P, Thorpe H, et al. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patient s with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 2005;365:1718-1726.
    CrossRef
  6. Veldkamp R, Kuhry E, Hop WC, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 2005;6:477-484.
    CrossRef
  7. Kim JH, Hur JM, Yoon SS, Kim SW, Shim MC, Kwun KB. Is laparoscopic procedure adequate for colorectal cancer surgery?. J Korean Soc Coloproctol 1999;15:434-442.
  8. Bennett CL, Stryker SJ, Ferreira MR, Adams J, Beart RW. The learning curve for laparoscopic colorectal surgery. Preliminary results from a prospective analysis of 1194 laparoscopic-assisted colectomi es. Arch Surg 1997;132:41-44.
    Pubmed CrossRef
  9. Joh YG, Kim SH, Yoon JS, Chung CS, Lee DK. Impact of body mass index on surgical outcomes of laparoscopic colorectal cancer resection. J Korean Soc Coloproctol 2003;19:243-247.
  10. Joh YG, Kim SH, Yoon JS, Cha YJ, Chung CS, Lee DK. An experience of laparoscopic resection for colorectal cancer in patients with previous abdominal surgery. J Korean Soc Coloproctol 2002;5:160-164.
  11. Kim SH, Milsom JW. Is laparo scopic technique oncologically appropriate for colorectal cancer surgery? J Korean Med Sci 1998;13:227-233.
    Pubmed KoreaMed CrossRef
  12. Goldstein NS. Lymph node recoveries from 2427 pT3 colorectal resection specimens spanning 45 years: recommendation for a minimum number of lymph nodes based on predictive probabilities. Am J Surg Pathol 2002;26:179-189.
    Pubmed CrossRef
  13. Goldstein NS, Sanford W, Coffey M, Layfield LJ. Lymph node recovery from colorectal resection specimens removed for adenocarcinoma. Trends over time and a recommendation for a minimum number of lymph nodes to be recovered. Am J Clin Pathol 1996;106:209-216.
    Pubmed CrossRef
  14. Schlachata CM, Mamazza J, Seshadri PA, et al. Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 2001;44:217-222.
    CrossRef
  15. Tekkis PP, Senagore AJ, Delaney CP, Fazio VW. Evaluation of the learning curve in laparoscopic colorectal surgery:comparison of right-sided and le ft-sided resections. Ann Surg 2005;242:83-91.
    Pubmed KoreaMed CrossRef

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