title: 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.
abstract: 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.
authors.affiliation: Department of Surgery, Buddhist Dalin Tzu Chi General Hospital, Chia-Yi, Taiwan. yaowen@mail.tcu.edu.tw
authors.forename: Wen-Yao
authors.initials: WY
authors.lastname: Yin
authors.forename: Chang-Kuo
authors.initials: CK
authors.lastname: Wei
authors.forename: Kuo-Chih
authors.initials: KC
authors.lastname: Tseng
authors.forename: Shih-Pin
authors.initials: SP
authors.lastname: Lin
authors.forename: Chun-Hung
authors.initials: CH
authors.lastname: Lin
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Chang
authors.forename: Ta-Wen
authors.initials: TW
authors.lastname: Hsu
mesh_terms: 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