Document Detail

Colorectal cancer: comparison of laparoscopic with open approaches.
MedLine Citation:
PMID:  9678367     Owner:  NLM     Status:  MEDLINE    
PURPOSE: We compared laparoscopic with open colectomy for treatment of colorectal cancer. METHODS: We performed a retrospective review of patients undergoing colectomy for colorectal cancer between January 1991 and March 1996 at a large private metropolitan teaching hospital. Operative techniques included open (n=90) and laparoscopic (n=80) colectomy. Laparoscopic colectomy was further subdivided into the following groups: facilitated (n=62), with extracorporeal anastomosis; near-complete (n=9), with small incision for specimen delivery only; complete (n=3), with specimen removal through the rectum; and converted to an open procedure (n=6). Main outcome measures included operative time, blood loss, time to oral intake, length of postoperative hospitalization, morbidity, lymph node yield, recurrence, survival, and costs. RESULTS: Operative time was equivalent in the laparoscopic and open groups (laparoscopic, 161 minutes; open, 163 minutes; P=0.94). Blood loss was less for the laparoscopic group (laparoscopic, 104 ml; open, 184 ml; P=0.001), and resumption of oral intake was earlier (laparoscopic, 3.9 days; open, 4.9 days; P=0.001), but length of hospitalization was similar. Mean lymph node yield in the laparoscopic group was 12 compared with 16 in the open group (P=0.16). Rates of morbidity, recurrence, and survival were similar in both groups. No port-site recurrences occurred. CONCLUSIONS: Laparoscopic and open colectomy were therapeutically similar for treatment of colorectal cancer in terms of operative time, length of hospitalization, recurrence, and survival rates. The laparoscopic approach was superior in blood loss and resumption of oral intake.
T M Khalili; P R Fleshner; J R Hiatt; T P Sokol; C Manookian; G Tsushima; E H Phillips
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  41     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-06     Completed Date:  1998-08-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  832-8     Citation Subset:  IM    
Department of Surgery, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
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MeSH Terms
Aged, 80 and over
Colectomy / methods*
Colorectal Neoplasms / pathology,  surgery*
Middle Aged
Neoplasm Staging
Retrospective Studies
Treatment Outcome

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