title: [Laparoscopic colectomy versus colectomy performed via laparotomy in the treatment of non-metastatic colic adenocarcinomas].
abstract: BACKGROUND
  Laparoscopic colectomy is considered with increasing frequency the gold standard treatment for colorectal cancer. Our study aims to show that short-term results and the oncological safety of laparoscopy are at least equivalent to those of laparotomy in the treatment of non-metastatic colic adenocarcinomas. We also highlight the impact of the learning curve on outcomes after laparoscopy in patients with these cancers.
  
  
  METHODS
  We conducted a retrospective study of all patients undergoing surgery for resectable colic adenocarcinomas over a period of 6 years. The study population was divided into 2 groups based on the surgical procedure used initially. The group "OC" included 35 patients who underwent midline laparotomy and the group "LAC" included 30 patients who underwent laparoscopy. All data were analyzed using SPSS software version 19.0.
  
  
  RESULTS
  Our study showed that there was no significant difference in short-term outcomes between the 2 groups, namely intraoperative morbidity, hospital stay, intensive care unit stay as well as postoperative morbidity and mortality. Regarding the long-term outcomes, there was also no significant difference in the incidence of late complications, type of recurrence, overall survival and disease-free survival. Oncological safety based on the limits of resection and the number of lymph nodes removed was not significantly different between the two groups. Operative time was significantly longer in the laparoscopic group (p <0.001). Convertion rate was 33%. It went from 67% in the first 2 years of the study to 13% in the last 2 years. The conversion from laparoscopy to laparotomy had no significant impact neither on early postoperative outcomes nor on overall survival and disease-free survival.
  
  
  CONCLUSIONS
  Laparoscopy is a surgical procedure resulting in at least equivalent short and long term outcomes as laparotomy. The learning curve representing a "prerequisite" has no negative impact on the outcomes of laparoscopic treatment of non-metastatic colic cancers.
authors.affiliation: Université de Tunis El Manar, Faculté de Medecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors.forename: Rached
authors.initials: R
authors.lastname: Bayar
authors.affiliation: Université de Tunis El Manar, Faculté de Medecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors.forename: Zeineb
authors.initials: Z
authors.lastname: Mzoughi
authors.affiliation: Université de Tunis El Manar, Faculté de Medecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors.forename: Achref
authors.initials: A
authors.lastname: Djebbi
authors.affiliation: Université de Tunis El Manar, Faculté de Medecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors.forename: Ghassen
authors.initials: G
authors.lastname: Halek
authors.affiliation: Université de Tunis El Manar, Faculté de Medecine de Tunis, 1007, Tunis, Tunisie; Service de Chirurgie Viscérale CHU Mongi Slim, Sidi Daoued La Marsa, Tunisie.
authors.forename: Mohamed Taher
authors.initials: MT
authors.lastname: Khalfallah
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D000368:Aged; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Laparoscopy; adenocarcinoma; colon; laparotomy