According to a recent article in the journal The Lancet, researchers have found laparoscopic-assisted surgery for colon cancer to be as effective as an open surgery and is likely to produce similar long-term outcomes. Its use for rectal cancer, however, remains uncertain.
Colorectal cancer is the second leading cause of cancer related deaths in the United States. It is a malignancy that involves both the large intestines (colon) and a distal portion of the colon known as the rectum. Current treatment options for colorectal cancer include surgery, radiation and chemotherapy. Chemotherapy is often used to destroy tumor cells, stabilize tumor growth or to control symptoms associated with colorectal cancer. Surgery for colon cancer may be performed using a laparoscopic approach or by a traditional open surgery. Laparoscopic surgery is a minimally invasive procedure that requires only small keyhole incisions in the abdomen, unlike traditional surgery where a long incision down the center of the abdomen is required. As a result, the patient may experience less pain and scarring, a shorter hospital stay, and a more rapid recovery.
In this recent study, researchers conducted a large multi-center study to compare the short-term outcomes of laparoscopic surgery and traditional open surgery for patients with colorectal cancer. Between July 1996 and July 2002, 794 patients with colorectal cancer were randomized to receive either laparoscopic-assisted surgery or open surgery. The goal of the study was to evaluate how completely the cancerous tissues could be removed, the types of tumors removed and the possibility of death while hospitalized. Results of the study found that only 737 actually had surgery, (253 open surgery, 484 laparoscopic assisted surgery). Of the 484 patients who underwent the laparoscopic-assisted surgery, 143 had to be converted to an open surgery due to their specific cases. Tumor types were similar among both groups, as well as the rate of hospital deaths, which were 5% and 4%, respectively. Rates of complete tissue removal were also similar among both groups. Additionally, both procedures were relatively well tolerated with the exception of the patients who required a conversion from laparoscopic surgery to open surgery. This group did experience higher rates of complications.
Researchers concluded that laparoscopic-assisted surgery for colon cancer is as effective as traditional open surgery and is likely to produce similar long-term outcomes. However, these researchers believe that the best outcomes can be achieved by surgeons who are well trained in advanced laparoscopic techniques, and by selecting patients may be considered a low risk for a conversion to open surgery.
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1.Guillou P, Quirke P, Thorpe H, et al. Short term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal ancer (MRC CLASICC trial): multicentre, randomized controlled study. The Lancet. 2005; 365: 1718-1726.
2.Curet, M. Laparoscopic-assisted Resection of Colorectal Carcinoma. The Lancet. 2005; 365: 1666-1668.
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