title: Peritoneal carcinomatosis is less frequently diagnosed during laparoscopic surgery compared to open surgery in patients with colorectal cancer.
abstract: BACKGROUND
  During resection of a colorectal tumor a careful inspection of the abdomen should be performed to detect metastases. The aim of the current study was to compare the proportions of patients diagnosed with peritoneal carcinomatosis (PC) during laparoscopic resection (LR) and open resection (OR).
  
  
  METHODS
  All patients who underwent resection for colorectal cancer in the Eindhoven Cancer Registry area between 2008 and 2012 were included. Proportions of patients with PC were compared between surgical techniques. Multivariate logistic regression analysis was performed.
  
  
  RESULTS
  6687 Patients underwent resection for colorectal cancer, of whom 1631 patients (24%) underwent LR, 4665 patients (70%) underwent OR. Conversion took place in 391 patients (19% of laparoscopic treated patients). PC was diagnosed in 1.4% of patients undergoing LR, in 5.0% of patients undergoing OR, and in 3.3% of patients in whom LR was converted to OR (p < 0.001). After adjustment for patient and tumor characteristics (e.g., T- and N-stage), patients who were treated by LR had a lower chance to be diagnosed with PC during surgery than patients undergoing OR (odds ratio = 0.42, p < 0.001).
  
  
  CONCLUSIONS
  Patients undergoing surgery for colorectal cancer are less frequently diagnosed with PC during LR in comparison to OR. Since effective treatment is currently available for selected patients with PC, a thorough inspection of the peritoneum during surgery is of paramount importance to offer these patients a chance for long-term survival and even cure.
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands; Eindhoven Cancer Registry, Comprehensive Cancer Centre South (IKZ), Eindhoven, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Thomassen
authors.affiliation: Eindhoven Cancer Registry, Comprehensive Cancer Centre South (IKZ), Eindhoven, The Netherlands.
authors.forename: Y R B M
authors.initials: YRBM
authors.lastname: van Gestel
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: A G J
authors.initials: AGJ
authors.lastname: Aalbers
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands.
authors.forename: T R
authors.initials: TR
authors.lastname: van Oudheusden
authors.affiliation: Department of Surgery, Elkerliek Hospital, Helmond, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Wegdam
authors.affiliation: Eindhoven Cancer Registry, Comprehensive Cancer Centre South (IKZ), Eindhoven, The Netherlands; Department of Public Health, Erasmus MC University Medical Centre, Rotterdam, The Netherlands.
authors.forename: V E P P
authors.initials: VEPP
authors.lastname: Lemmens
authors.affiliation: Department of Surgery, Catharina Hospital, Eindhoven, The Netherlands. Electronic address: ignace.d.hingh@cze.nl.
authors.forename: I H J T
authors.initials: IHJT
authors.lastname: de Hingh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000556:secondary*; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology* / Q000601:surgery; D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010534:Peritoneal Neoplasms / Q000556:secondary*; D011379:Prognosis; D012042:Registries
keywords: Laparoscopy; Open surgery; Peritoneal carcinomatosis; Staging