Open colectomy versus laparoscopic-assisted colectomy supported by hand-assisted laparoscopic colectomy for resectable colorectal cancer: a comparative study with minimum follow-up of three years.
OBJECTIVE
Although laparoscopic colorectal cancer surgery is not widely used for several reasons especially for concerning inadequate resection, recent data showed equivalent oncologic outcomes between open colectomy (OC) and laparoscopic-assisted colectomy (LAC). However, there is no clinical trial for the LAC supported by hand-assisted laparoscopic colectomy (HALC), named as LAC/HALC.


METHODS
Patients were assigned to either OC or LAC/HALC group. Clinical data, operation times, conversion rates from LAC to HALC, complications, early results, and long-term results were analyzed retrospectively.


RESULTS
The short-term outcomes including pain, ambulation, oral resumption, wound infections, and hospital stays were favorable for LAC/HALC group. HALC was subsequently required in seven LAC cases but none of them required open colectomies. Functional recovery was the benchmark for early discharge for LAC/HALC group. Specimen size and number of lymph nodes harvested were similar. Local recurrence, disease-free and overall survival rates were comparable.


CONCLUSIONS
The current study demonstrated that LAC/HALC was associated with favorable recoveries even in oncologic clearance in the long-term follow-up. HALC reduces the conversion rate from LAC to OC and maintains the benefits of minimal invasive surgery. Therefore, we suggest LAC/HALC is a suitable surgical hybrid for the treatment of resectable colorectal cancers.
Yin
Wen-Yao
WY
Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan. yaowen@mail.tcu.edu.tw
Wei
Chang-Kuo
CK
Tseng
Kuo-Chih
KC
Lin
Shih-Pin
SP
Lin
Chun-Hung
CH
Chang
Chun-Ming
CM
Hsu
Ta-Wen
TW
D000368:Aged; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome