title: Survival following laparoscopic and open colorectal surgery.
abstract: BACKGROUND
  Laparoscopic colorectal surgery is known to provide increased benefits to patients during the postoperative recovery period. Initial scepticism over the oncological adequacy of resection has been dismissed by a number of major randomized trials. Emerging evidence indicates that laparoscopic surgery may provide a potential survival benefit in colorectal cancer.
  
  
  METHODS
  Patients undergoing elective laparoscopic or open resection for colorectal cancer between October 2003 and December 2010 were analyzed. Data were collated and a database compiled. Survival analysis was calculated by using the Kaplan-Meier method.
  
  
  RESULTS
  A total of 665 resections were performed with 457 laparoscopically and 208 open. The median length of stay was 4 days following laparoscopic resection and 7 days following open (p < 0.0005). There was no significant difference between the two groups apart from gender (p = 0.03), ASA (p = 0.03), and the number of patients with extranodal metastatic disease (p = 0.01). The 5-year overall survival (OS) in the completed laparoscopic group was 75.8 versus 72.5 % in the open group (p = 0.12). The 5-year OS in patients who were converted was 52 %. The 5-year OS for nonmetastatic disease in the completed laparoscopic group was significantly greater at 79.4 versus 74 % in the open group (p = 0.03). There was no difference between the groups in OS for rectal cancer (p = 0.66), but there was an OS advantage for laparoscopically resected colon cancer (p = 0.02).
  
  
  CONCLUSIONS
  Laparoscopic resection for nonmetastatic colon cancer may provide an overall survival advantage.
authors: Minimal Access Therapy Training Unit, Postgraduate Medical School, University of Surrey, Manor Park, Guildford, UK. dayandrew@hotmail.co.uk
authors: Andrew R
authors: AR
authors: Day
authors: Ralph V P
authors: RV
authors: Smith
authors: Iain C
authors: IC
authors: Jourdan
authors: Tim A
authors: TA
authors: Rockall
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy / Q000401:mortality*; D007902:Length of Stay; D008207:Lymphatic Metastasis; D008297:Male; D012189:Retrospective Studies; D012737:Sex Factors
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