Introduction. Aim of our study was to compare the results of the laparoscopic technique to those obtained by traditional open approach
in patients with colon cancer.
The advantages, disadvantages, and the contraindications (real and presumptive) of this mini-invasive approach are described, by comparing the data obtained from the international literature with our clinical experience.
Patients and methods. From February 2000 to May 2006,
we performed 73 laparoscopic colectomies for cancer in the Operative Unit of General and Laparoscopic Surgery, Department of
Surgical Sciences of the University of Chieti, Italy. The data of these patients were compared with the data obtained from 141 other
patients who underwent open procedure for the same pathology in
the same period and in the same Unit. Factors such as obesity, previous major abdominal surgery, T4 cancers, perforation and obstruction of the colon, tumor located in the transverse colon or in
the left flexure of the colon were considered contraindications to laparoscopic approach.
Results. The length of surgical specimens and the number of
lymph nodes removed did not show significant differences in the two
groups. Two patients in the open procedure group died in the postoperative period. No postoperative death was noted in the group of patients operated by laparoscopic method. Postoperative complications
requiring re-operation were observed in 9 patients in the open group
and in 3 patients of laparoscopic group. Postoperative complications
not requiring re-operation were observed in 16 patients in the open
group and in 4 patients in laparoscopic group. Hospital stay was
shorter for laparoscopic right or left colectomy compared to corresponding open procedures.
At the follow-up (a mean 30 months), the overall survival
was 78% for open colectomies and 82.1% for laparoscopic colectomies. Disease-free survival, excluding patients with stage IV tumor and patients died in the postoperative period, was 77.6% for
open colectomies and 82.5% for laparoscopic colectomies. In the
group of laparoscopic patients, we observed 1 case of port-site recurrence