title: Multicenter study of short- and long-term outcomes of laparoscopic palliative resection for incurable, symptomatic stage IV colorectal cancer in Japan.
abstract: BACKGROUND
  This Japanese multicenter retrospective study evaluated short- and long-term outcomes of palliative laparoscopic procedures for symptomatic stage IV colorectal cancer compared with conventional open procedures.
  
  
  METHODS
  Of 968 eligible patients with stage IV colorectal cancer enrolled during January 2006-December 2007 from 41 participating surgical units (Japan Society of Laparoscopic Colorectal Surgery Group), we studied 409 patients who underwent palliative resection of symptomatic primary colorectal tumor.
  
  
  RESULTS
  Data from patients with laparoscopic resection (n = 98) and open colorectal resection (n = 311) were analyzed. Eleven (11.2 %) laparoscopic operations were converted to an open procedure. Fewer complications were reported for laparoscopic resections than for open procedures (13.3 vs. 26.7 %; p = 0.0042). Postoperative hospital stay was significantly shorter in the laparoscopic vs. open resection group (median, 14 vs. 17 days; p = 0.0242). Postoperative chemotherapy treatment was administered to 245 (78.9 %) patients in the open and 78 (79.6 %) patients in the laparoscopic resection group. Time from surgery to start of postoperative chemotherapy was significantly shorter in the laparoscopic vs. open resection group (median, 32 vs. 27 days; p = 0.0487). Median survival time between the two groups was not significantly different (22.0 vs. 22.2 months; p = 0.948).
  
  
  CONCLUSIONS
  Laparoscopic palliative resection results in reduced postoperative complications and earlier recovery with acceptable long-term outcomes comparable with open surgery. When performed by experienced surgeons in selected patients, it may be a safe and feasible option. Because of the potential of significant bias arising from the included studies, further randomized controlled trials should be undertaken to confirm this bias.
authors: Department of Surgery I, Faculty of Medicine, Oita University, Oita, Japan.
authors: Tomonori
authors: T
authors: Akagi
authors: Masafumi
authors: M
authors: Inomata
authors: Seigo
authors: S
authors: Kitano
authors: Koya
authors: K
authors: Hida
authors: Yoshiharu
authors: Y
authors: Sakai
authors: Suguru
authors: S
authors: Hasegawa
authors: Yousuke
authors: Y
authors: Kinjo
authors: Kenichi
authors: K
authors: Yoshimura
authors: Masaaki
authors: M
authors: Ito
authors: Yosuke
authors: Y
authors: Fukunaga
authors: Akiyoshi
authors: A
authors: Kanazawa
authors: Hitoshi
authors: H
authors: Idani
authors: Masahiko
authors: M
authors: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult