Jacopo Desiderio1, Stefano Trastulli2, Francesco Ricci2, Jacopo Penzo3, Roberto Cirocchi4, Federico Farinacci2, Carlo Boselli3, Giuseppe Noya3, Adriano Redler5, Alberto Santoro5, Amilcare Parisi6. 1. Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: djdesi85@hotmail.it. 2. Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. 3. Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. 4. Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: cirocchiroberto@yahoo.it. 5. Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy. 6. Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it.
Abstract
BACKGROUND: Laparoscopic left colectomy has obtained a large spread in colon surgery for malignant disease despite the need for an adequate learning curve. However few studies reported long term data in comparison with open left colectomy and most of the authors of large series on colorectal surgery don't describe, in subgroup analysis, results obtained in left colonic resections. The aim of this study is to report the short and long term follow-up of laparoscopic left colon resection in comparison with the open approach, from a single centre, performed in the same timeframe. METHODS: Between January 2005 to January 2007, 55 patients with sigma adenocarcinoma underwent to laparoscopic or open left colectomy at the Department of Digestive Surgery, "S. Maria" hospital in Terni - Italy. Perioperative and histopathological data and results from oncological follow-up, until April 2013, are analyzed. RESULTS: 28 patients underwent laparoscopic left colectomy, while 27 patients open left colectomy. Mean hospital stay was 8.44 ± 1.21 in the laparoscopic group versus 6.86 ± 1.01 in the open group. The histopathological analysis shows a mean of 18.13 ± 6.8 lymph nodes removed after laparoscopy and 13.96 ± 5.72 after open surgery (P = 0.02). Kaplan-Meier analysis does not reveal significative differences in disease free survival (HR = 0.85; 95% CI = 0.21-3.40; P = 0.81). Overall survival up to 5 years shows one death per group. CONCLUSIONS: Laparoscopy, respect to the open approach, could improve perioperative clinical outcomes, hospital stay and harvested lymph nodes with comparable long term oncological follow-up in patients with sigmoid colon cancer.
BACKGROUND: Laparoscopic left colectomy has obtained a large spread in colon surgery for malignant disease despite the need for an adequate learning curve. However few studies reported long term data in comparison with open left colectomy and most of the authors of large series on colorectal surgery don't describe, in subgroup analysis, results obtained in left colonic resections. The aim of this study is to report the short and long term follow-up of laparoscopic left colon resection in comparison with the open approach, from a single centre, performed in the same timeframe. METHODS: Between January 2005 to January 2007, 55 patients with sigma adenocarcinoma underwent to laparoscopic or open left colectomy at the Department of Digestive Surgery, "S. Maria" hospital in Terni - Italy. Perioperative and histopathological data and results from oncological follow-up, until April 2013, are analyzed. RESULTS: 28 patients underwent laparoscopic left colectomy, while 27 patients open left colectomy. Mean hospital stay was 8.44 ± 1.21 in the laparoscopic group versus 6.86 ± 1.01 in the open group. The histopathological analysis shows a mean of 18.13 ± 6.8 lymph nodes removed after laparoscopy and 13.96 ± 5.72 after open surgery (P = 0.02). Kaplan-Meier analysis does not reveal significative differences in disease free survival (HR = 0.85; 95% CI = 0.21-3.40; P = 0.81). Overall survival up to 5 years shows one death per group. CONCLUSIONS: Laparoscopy, respect to the open approach, could improve perioperative clinical outcomes, hospital stay and harvested lymph nodes with comparable long term oncological follow-up in patients with sigmoid colon cancer.
Authors: Ju Myung Song; Ji Hoon Kim; Yoon Suk Lee; Ho Young Kim; In Kyu Lee; Seung Teak Oh; Jun Gi Kim Journal: Ann Surg Treat Res Date: 2016-09-30 Impact factor: 1.859