Comparison of mini laparotomy with conventional laparotomy as the surgical approach in stage I-III CRC patients: appealing outcomes.
OBJECTIVE
Mini laparotomy is technical for the resection of colorectal cancer (CRC) in selected patients. The aim was to compare clinical outcomes of mini laparotomy with conventional laparotomy in CRC patients.


METHODS
Between january 2007 and june 2010, 138 patients and 117 patients underwent elective resection using either mini laparotomy or conventional laparotomy respectively. Mini laparotomy involved a colorectal resection performed through a skin incision ≤8 cm in length. Clinicopathological factors, operative procedure and postoperative course were retrospectively analyzed to compare clinical outcomes between the two groups.


RESULTS
Mini laparotomy seems to be an attractive alternative for resection of CRC in selected patients. Clinicopathological and histopathological features were similar between both groups, whereas intraoperative blood loss, operative time and harvested lymph-node numbers in conventional laparotomy were significantly greater (p=0.003, p=0.008 and p=0.024, respectively). Postoperative relapse, complications and hospitalization were significantly better in the mini laparotomy (all p<0.001). In comparison of postoperative complications between convention and mini laparotomy, ileus was more frequently encountered in conventional group (p=0.001). Interestingly, the disease-free survival and overall survival in mini laparotomy group were significantly better than control group (p=0.001 and p=0.017, respectively).


CONCLUSIONS
Compared to conventional laparotomy, mini laparotomy seems a feasible, minimally invasive and attractive alternative in selected patients.
Department of Surgery, Division of General Surgery Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hsiang-Lin
HL
Tsai
Ming-Jenn
MJ
Chen
Yung-Sung
YS
Yeh
Chao-Wen
CW
Chen
Li-Chu
LC
Sun
Chien-Yu
CY
Lu
I-Ping
IP
Yang
Jaw-Yuan
JY
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome