Laparoscopic Resection of Colon Cancer: Early Oncologic Outcomes

ABSTRACT

PURPOSE: The aim of this study was to evaluate the interim oncologic outcome following a laparoscopic resection of colon cancer. METHODS: Prospectively collected data was obtained on 119 patients (M:F=60:59, mean age=56 years) undergoing a laparoscopic colon-cancer resection between January 2001 and May 2004. Fifty-nine tumors were in the sigmoid, 17 in the right colon, 15 in the transverse colon, 12 in the hepatic flexure, 12 in the left colon, 10 in the cecum, and 4 in the splenic flexure. RESULTS: The operative procedures included 51 sigmoidectomies, 48 right colectomies, 15 left colectomies, 3 transverse colectomies, and 2 total abdominal colectomies. The mean operative time was 186 minutes. The mean blood loss was 91 ml. Conversion to an open procedure was not required. TNM stages were 0 in 11 patients, I in 19, II in 55, III in 30, and IV in 4. The portion of T3 plus T4 was 73%. The mean number of resected lymph nodes was 27. The mean proximal and distal margins were 14 cm and 12 cm. The overall morbidity rate was 26% (15 wound seromas/ abscesses, 5 chylous leaks, 3 perianastomotic inflammations, 2 ileus, 2 intraabdominal bleedings, 1 anastomotic leak, 1 anastomotic obstruction, 1 intractable hiccup, 1 fungal peritonitis). There were no operative mortalities. The mean hospital stay was 10 days. Ninety eight patients were followed-up longer than 6 months (median 19 months, range 6~0 months) after the curative resection. Distant metastases occurred in 3 stage-IIIB and 3 stage-IIIC patients (6%): liver (2), liver & peritoneum (1), lung (1), paraaortic and iliac lymph nodes (1), and peritoneum (1). The mean time to recurrence was 10.3 months after the operation There were no local or port-site recurrences. CONCLUSIONS: In this study, Laparoscopic resections of colon cancer provided an acceptable morbidity rate and satisfactory early oncologic outcomes. Long-term follow-up is mandatory and ongoing.