Abstract
Background
The large randomized trials reporting on laparoscopic versus open colon surgery for cancer have all excluded patients with transverse colon cancer lesions. This study was undertaken to review our experience with surgery for curable transverse colon cancer.
Methods
A database of 938 laparoscopic colon resections performed between April 1991 and September 2004 was reviewed. Of 514 procedures for cancer, stage IV disease, mid to low rectal cancers, and total colectomies were excluded. On an intent-to-treat basis, outcomes of surgery for transverse colon lesions (TC) were compared with outcomes of segmental colon resections for other lesions (OC).
Results
A total of 22 TC were resected compared with 285 OC. Patients with TC were similar to patients with OC in age, gender, weight, and body mass index (BMI). Cancer stage was equivalent between patients with TC (9 Stage I, 7 Stage II, 6 Stage III) and OC (66 Stage I, 126 Stage II, 93 Stage III, p = 0.170) as was tumor size. Patients with TC underwent 9 transverse colectomies, 12 extended right hemicolectomies, and 1 extended left hemicolectomy. Patients with OC underwent 126 right hemicolectomies, 24 left hemicolectomies, and 135 sigmoid colectomies or anterior resections. There were no differences in conversion rate (18.2% vs. 13.3%, p = 0.752) or in intraoperative (9% vs. 8%, p = 0.814) or postoperative (41% vs. 30%, p = 0.418) complications. Operating time was longer with TC (209 ± 63 min vs. 176 ± 60 min, p = 0.042) and lymph node harvest was higher (15.3 ± 11.6 vs. 10.8 ± 7.6, p = 0.011). At a median followup of 17.2 months and 17.1 months, respectively, there were two (9%) recurrences after resection of TC and 17 (6%) recurrences after resection of OC.
Conclusions
Laparoscopic resection of transverse colon cancers is technically feasible and not associated with a significantly higher rate of complications or conversions or with impaired oncologic outcomes compared with patients having segmental laparoscopic resections for other colon cancers. Operating time is longer.
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References
Clinical Outcomes of Surgical Therapy Study Group (2004) A comparison of laparoscopic assisted and open colectomy for colon cancer. N Engl J Med 350(20): 2050–2059
Fowler DL, White SA (1991) Laparoscopy-assisted sigmoid resection. Surg Laparosc Endosc 1: 183–188
Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM, MRC CLASICC trial group (2005) Short-term endpoint of conventional versus laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 365(9472): 1718–1726
Jacobs M, Verdeja JC, Goldstein HS (1991) Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1: 144–150
Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, Visa J (2002) Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet 359(9325): 2224–2229
Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, Lai PB, Lau WY (2004) Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet 363(9416): 1187–1192
Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy AM, Colon cancer Laparoscopic or Open Resection Study Group (COLOR) (2005) Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol 6(7): 477–484
Schlachta CM, Mamazza J, Gregoire R, Burpee SE, Poulin EC (2003) Could laparoscopic colon and rectal surgery become the standard of care? A review and experience with 750 procedures. Can J Surg 46(6): 432–440
Zucker KA, Pitcher DE, Martin DT, Ford RS (1994) Laparoscopic assisted colon resection. Surg Endosc 8: 12–17
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Presented at the 13th International Congress of the European Association for Endoscopic Surgery, Venice, Italy, June 2–4, 2005
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Schlachta, C.M., Mamazza, J. & Poulin, E.C. Are transverse colon cancers suitable for laparoscopic resection?. Surg Endosc 21, 396–399 (2007). https://doi.org/10.1007/s00464-006-9042-6
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DOI: https://doi.org/10.1007/s00464-006-9042-6