Randomized controlled trial of laparoscopic versus open colectomy for advanced colorectal cancer.
BACKGROUND
After confirming a favorable outcome of laparoscopic surgery for early colorectal cancer, we conducted a randomized controlled trial to compare short-term outcomes of laparoscopic and open colectomy for advanced colorectal cancer.


METHODS
Fifty-nine patients with T2 or T3 colorectal cancer were randomized to undergo laparoscopic (n = 29) or open (n = 30) colectomy. Median follow-up was 20 months (range, 6-34 months).


RESULTS
Operative time was longer (p <0.0001) and blood loss (p = 0.0034) and postoperative analgesic requirement were less in the laparoscopic group than in the open group. An earlier return of bowel motility and earlier discharge from the hospital (p = 0.0164) were observed after laparoscopic surgery. Serum C-reactive protein levels on postoperative days 1 (p <0.0001) and 4 (p = 0.0039) were lower in the laparoscopic group than in the open group. Postoperative complications did not differ between the two groups.


CONCLUSIONS
Laparoscopic surgery for advanced colorectal cancer is feasible, with favorable short-term outcome.
Hasegawa
H
H
Department of Surgery, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
Kabeshima
Y
Y
Watanabe
M
M
Yamamoto
S
S
Kitajima
M
M
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000097:blood / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D007694:Killer Cells, Natural; D010535:Laparoscopy; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D016896:Treatment Outcome
D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein