Long-term outcomes of laparoscopic surgery for advanced transverse colon cancer.

BACKGROUND

The role of laparoscopic surgery for advanced transverse colon cancer (TCC) remains controversial, especially in terms of long-term oncologic outcomes.

METHODS

This retrospective cohort study enrolled 157 consecutive patients who underwent curable resections for advanced TCC between January 2002 and June 2011 (laparoscopic-assisted colectomy (LAC), n = 74; open colectomy (OC), n = 83). Short-term outcomes and oncologic long-term outcomes were compared between the two groups.

RESULTS

Compared to the OC group, patients in the LAC group had less blood loss (LAC vs. OC, 79.6 ± 70.3 vs. 158.4 ± 89.3 ml, p < 0.001), faster return of bowel function (2.6 ± 0.7 vs. 3.8 ± 0.8 days, p < 0.001), and shorter postoperative hospital stay (10.3 ± 3.7 vs. 12.6 ± 6.0 days, p = 0.007). Conversions were required in four (5.4%) patients. Rates of short-term complication, mortality, and long-term complication were comparable between the two groups. The median follow-up time was 54 (26-106) months in the LAC group and 58 (29-113) months in the OC group (p = 0.407). There were no statistical differences in the rates of 5-year overall survival (73.6 vs. 71.1%, p = 0.397) and 5-year disease-free survival (70.5 vs. 66.7%, p = 0.501) between the two groups.

CONCLUSIONS

Laparoscopic surgery for advanced TCC yield short-term benefits while achieving equivalent long-term oncologic outcomes.