Laparoscopic-assisted surgery versus open surgery for transverse colon cancer: A multicenter retrospective study
Hiroshi Tamagawa1, Masakatsu Numata1, Toru Aoyama1, Keisuke Kazama1, Yukio Maezawa1, Yosuke Atsumi1, Kentaro Hara1, Kazuki Kano1, Keisuke Komori1, Shinnosuke Kawahara1, Norio Yukawa1, Sho Sawazaki2, Hiroyuki Saeki2, Teni Godai3, Yasushi Rino1, Munetaka Masuda1
1 Department of Surgery, Yokohama City University, Yokohama, Japan
2 Department of Surgery, Yokohama Minami Kyosai Hospital, Yokohama, Japan
3 Department of Surgery, Fujisawa Shonandai Hospital, Takakura, Fujisawa, Japan
Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa, Yokohama 236-0004
Source of Support: None, Conflict of Interest: None
Introduction: Previous randomized controlled trials demonstrated similar oncological outcomes between laparoscopic-assisted (LA) and open (OP) colectomy; however, patients with transverse colon cancer were not analyzed. The aim of this study was to confirm the oncological safety and the advantages of the short- and long-term results of LA surgery for transverse colon cancer in comparison to OP surgery.
Materials and Methods: The study data were retrospectively collected from the databases of four hospitals. Patients with transverse colon cancer who underwent LA or OP R0 or R1 resection were registered.
Results: Among the 204 patients, 149 underwent OP colectomy and 55 underwent LA colectomy. The median follow-up period was 43 months. The rate of conversion to OP resection was 7.3%. The 5-year overall survival rate of the LA group was higher than that of the OP surgery group for all-stage patients (97.5% vs. 91.1%, P = 0.108), and it was similar in Stage II and Stage III patients (94.1% vs. 94.2%, P = 0.510). The LA group had significantly lower blood loss and a significantly longer operative time in comparison to the OP surgery group. Furthermore, the postoperative hospital stay was significantly shorter (9 vs. 13 days, P = 0.001) and the incidence of Grade ≥III complications was lower in the LA group (3.7% vs. 14.8%, P = 0.031).
Conclusion: We concluded that LA surgery for transverse colon cancer is oncologically safe and yields better short-term results in comparison to OP surgery.