title: Endo-laparoscopic approach versus conventional open surgery in the treatment of obstructing left-sided colon cancer: long-term follow-up of a randomized trial.
abstract: BACKGROUND
  We previously conducted a randomized trial comparing the endo-laparoscopic approach (i.e. placing self-expanding metallic stents followed by laparoscopic resection) and conventional open surgery in the treatment of obstructing left-sided colon cancer. This study is a follow-up of the previous randomized trial and aims to report the long-term outcomes of the two groups.
  
  
  METHODS
  Forty-eight patients from the randomized trial were followed up in an outpatient clinic with regular monitoring. Patients were compared for clinicopathological variables, disease recurrence and survival rates.
  
  
  RESULTS
  Clinicopathological details were comparable between the two groups. During the median follow-up periods of 32 months for the open group and 65 months endo-laparoscopic group, no statistically significant difference was observed between the groups in disease recurrence rate, 5-year overall survival (27% vs 48%, P = 0.076) and 5-year disease-free survival rates (48% vs 52%, P = 0.63).
  
  
  CONCLUSIONS
  Besides being a safe bridge to subsequent elective laparoscopic surgery, preoperative self-expanding metallic stents insertion does not adversely affect oncological outcomes and patient survival. Based on our data, the endo-laparoscopic approach is the treatment of choice for patients presenting with malignant left-sided colonic obstruction.
authors.affiliation: Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. karmanes_t@yahoo.com.hk
authors.forename: Karen Lok Man
authors.initials: KL
authors.lastname: Tung
authors.forename: Hester Yui Shan
authors.initials: HY
authors.lastname: Cheung
authors.forename: Lawrence Wing Chiu
authors.initials: LW
authors.lastname: Ng
authors.forename: Cliff Chi Chiu
authors.initials: CC
authors.lastname: Chung
authors.forename: Michael Ka Wah
authors.initials: MK
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy; D003110:Colonic Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007415:Intestinal Obstruction / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015607:Stents; D016019:Survival Analysis; D016896:Treatment Outcome