title: Laparoscopic versus open left colectomy in patients with sigmoid colon cancer: prospective cohort study with long-term follow-up.
abstract: BACKGROUND
  Laparoscopic left colectomy has obtained a large spread in colon surgery for malignant disease despite the need for an adequate learning curve. However few studies reported long term data in comparison with open left colectomy and most of the authors of large series on colorectal surgery don't describe, in subgroup analysis, results obtained in left colonic resections. The aim of this study is to report the short and long term follow-up of laparoscopic left colon resection in comparison with the open approach, from a single centre, performed in the same timeframe.
  
  
  METHODS
  Between January 2005 to January 2007, 55 patients with sigma adenocarcinoma underwent to laparoscopic or open left colectomy at the Department of Digestive Surgery, "S. Maria" hospital in Terni - Italy. Perioperative and histopathological data and results from oncological follow-up, until April 2013, are analyzed.
  
  
  RESULTS
  28 patients underwent laparoscopic left colectomy, while 27 patients open left colectomy. Mean hospital stay was 8.44 ± 1.21 in the laparoscopic group versus 6.86 ± 1.01 in the open group. The histopathological analysis shows a mean of 18.13 ± 6.8 lymph nodes removed after laparoscopy and 13.96 ± 5.72 after open surgery (P = 0.02). Kaplan-Meier analysis does not reveal significative differences in disease free survival (HR = 0.85; 95% CI = 0.21-3.40; P = 0.81). Overall survival up to 5 years shows one death per group.
  
  
  CONCLUSIONS
  Laparoscopy, respect to the open approach, could improve perioperative clinical outcomes, hospital stay and harvested lymph nodes with comparable long term oncological follow-up in patients with sigmoid colon cancer.
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: djdesi85@hotmail.it.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Desiderio
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ricci
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Penzo
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy. Electronic address: cirocchiroberto@yahoo.it.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Farinacci
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Noya
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Adriano
authors.initials: A
authors.lastname: Redler
authors.affiliation: Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Department of Digestive Surgery and Liver Unit, St. Maria Hospital, Terni, Italy. Electronic address: amilcareparisi@virgilio.it.
authors.forename: Amilcare
authors.initials: A
authors.lastname: Parisi
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003082:Colectomy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012811:Sigmoid Neoplasms / Q000401:mortality / Q000601:surgery*; D016896:Treatment Outcome