title: Laparoscopic treatment of advanced colonic cancer: a case-matched control with open surgery.
abstract: OBJECTIVE
  The safety, feasibility and oncological results of laparoscopic resection for advanced colon cancer were evaluated.
  
  
  METHODS
  Seventy consecutive patients with a histologically proven T4 colon cancer who underwent laparoscopic (LPS) right or left colectomy were matched for comorbidity on admission (American Society of Anesthesiologists score), tumour stage and grading with 70 patients who underwent open colectomy over a 10-year period. Short- and long-term outcome measures were evaluated.
  
  
  RESULTS
  The overall conversion rate was 7.1%. Less intra-operative blood loss (P = 0.01), a trend toward a longer operation time (P = 0.09) and a lower peri-operative blood transfusion rate (P = 0.06) were observed in the LPS group. A similar number of lymph nodes were retrieved (P = 0.37) and the R1 resection rate (P = 0.51) was no different in the two groups. The overall mortality rate was 1.4%. The overall morbidity rate was 21.4% (15/70 patients) in the LPS group and 27.5% (19/70 patients) in the open group (P = 0.42), with anastomotic leakage rates of 7.1% and 4.2% (P = 0.32). Length of stay was shorter after LPS (P = 0.009). Five-year overall survival rate (P = 0.18) and disease-free survival rate (P = 0.20) did not differ significantly between the two groups.
  
  
  CONCLUSIONS
  Laparoscopic treatment of T4 colon cancer is safe and feasible and provides a similar surgical and oncological outcome compared with the open technique.
authors: Department of Surgery, San Raffaele Scientific Institute, University Vita Salute, Milan, Italy. vignali.andrea@hsr.it
authors: A
authors: A
authors: Vignali
authors: L
authors: L
authors: Ghirardelli
authors: S
authors: S
authors: Di Palo
authors: E
authors: E
authors: Orsenigo
authors: C
authors: C
authors: Staudacher
mesh_terms: D000368:Aged; D057868:Anastomotic Leak; D016063:Blood Loss, Surgical / Q000706:statistics & numerical data; D001803:Blood Transfusion / Q000706:statistics & numerical data; D003082:Colectomy / Q000009:adverse effects* / Q000401:mortality; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000009:adverse effects* / Q000401:mortality; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Laparoscopy; T4 colon cancer; multivisceral resection; oncological results