Comparison of Short-Term Results of Laparoscopy and Open Surgery for Colorectal Cancer: A Single-Center Experience

2022 ◽  
Vol 9 (1) ◽  
pp. 34-37
Author(s):  
Dogukan Durak ◽  
Ertugrul Gazi Alkurt ◽  
Veysel Barış Turhan
Keyword(s):  
Laparoscopic Surgery ◽  
Lymph Nodes ◽  
Open Surgery ◽  
Median Number ◽  
Oral Feeding ◽  
Pathology Report ◽  
Laparoscopy Group ◽  
Surgery Group ◽  
Icu Discharge ◽  
Malignant Lymph Nodes

Objective: Although laparoscopic colon cancer surgeries have increased in recent years, their oncological competence is questioned. In our study, we aimed to evaluate oncological competence by comparing laparoscopic and open surgery. Material and Methods: The study was planned retrospectively. A total of 94 patients were included in the study, 42 of whom underwent laparoscopy, and 52 patients underwent open surgery. Both groups were compared in terms of demographic characteristics, staging, number of benign/malignant lymph nodes, histological findings and complications. Result: The final pathology report of all patients was adenocarcinoma. The median number of dissected lymph nodes was 20.9 in the open group (8-34) and 19.46 in the laparoscopy group (7-31) (p=0.639). The median number of dissected malignant lymph nodes was 1 (0-13) in the open surgery group and 3.1 (0-8) in the laparoscopy group (p=0.216). The laparoscopy group exhibited a longer operation time (281.2±54.2 and 221.0±51.5 min, respectively; P=0.036) than the open surgery group, but a shorter intensive care unit(ICU) discharge, quicker initiation oral feeding, and shorter length of hospital stay (4.0±0.9 vs. 5.7±2.0 days, respectively; P<0.001). Discussion: Laparoscopic surgery elicits many benefits such as less wound infection, lower requirement for blood transfusion, shorter hospitalization, quicker initiation of oral feeding and mobilization. Our study has shown that laparoscopic surgery provides quite adequate lymph node dissection when compared with oncological surgery, which is viewed with suspicion in the light of these benefits of laparoscopy.

Assessment of Circumferential Resection Margins (CRM) clearance in Conventional open Versus Laparoscopic Cancer Rectum Resection

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ibrahim H Bayan ◽  
Ahmed Abdelaziz ◽  
Tarek Youssef Ahmed ◽  
Mohamed Magdy
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Abdominal Surgery ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Resection Margins ◽  
Laparoscopy Group ◽  
Surgery Group ◽  
Colon And Rectal Cancer ◽  
Significant Difference

Abstract Background Colon and rectal cancer represent the fourth commonest malignancy worldwide. Globally, colon and rectal cancer make up 9.4% and 10.1% in men and women of all cancers, respectively. Colon and rectal tumors are the third most common malignancy after breast and lung cancer, respectively. The main management of rectal cancer involves a multi-disciplinary team approach and an individually tailored treatment routine. Operative surgery remains the primary and definitive treatment for locally confined rectal adenocarcinoma and is the only historical and current treatment which allows for cure. Resection of the colon and rectal cancer can be done either by open surgical excision or laparoscopically. Aim of the work The objective is to compare the radicality of total mesorectal excision for rectal cancer in both open and laparoscopic surgery through the pathology report. Methods In this multicentric, prospective, comparative study, we included the pathologically established rectal cancer patients from 2 hospitals in Cairo, Egypt, Ain Shams University Hospitals and Maadi Military Hospital, Egypt between 2013 and 2016. The sample size was 40 patients divided into two groups; 20 patients for laparoscopic arm and 20 patients for the open trans-abdominal surgery. Inclusion criteria: histopathology confirmed rectal cancer, patients fit for operative resection, and with T1- T3 grades according to the preoperative evaluation. The exclusion criteria: Patients with T4 stage tumor, patients present as emergency cases and patients present with recurrence of the tumor and synchronous colonic tumors. Results The circumferential resection margins (CRM) of the mesorectum when examined pathologically after resection showed no difference between the two arms of the study with laparoscopic group specimens 3.18±1.16 mm mean, (SD) compared to 3.50±0.45 mm mean, (SD) in the open surgery group with no statistically significant difference. The longitudinal resection margins (LRM) was (5.50±1.98 mean, SD) in the laparoscopic group compared to (5.20±2.28 mean, SD) in the open conventional surgery group with no significant difference found between the two groups. Total operative time was significantly shorter in the trans-abdominal surgery group, while the hospital stay period was significantly shorter in the laparoscopy group. Laparoscopy group also showed significantly time before flatus passage, and the patients in the laparoscopy group started oral intake faster than open surgery group. Conclusion In our study, the radicality of the rectal cancer excision in both laparoscopic and traditional open surgery, showed non inferiority of the laparoscopic technique over open surgery Long-term clinical outcomes of overall survival and recurrence is the foremost parameters which should be taken in consideration for decision for laparoscopic surgery for rectal cancer. Additional follow-up results from the current trial are presently being developed, beside with records on other secondary end points, like cost effectiveness and quality of life.

Laparoscopic Versus Open Appendectomy for the Treatment of Complicated Acute Appendicitis

2020 ◽  
Vol 8 (1) ◽  
pp. 15
Author(s):  
Alireza Barband ◽  
Amir Mangouri ◽  
Changiz Gholipouri ◽  
Abasad Gharedaghi
Keyword(s):  
Laparoscopic Surgery ◽  
Surgical Treatment ◽  
Postoperative Pain ◽  
Acute Appendicitis ◽  
Open Surgery ◽  
Surgery Group ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Duration Of Hospitalization ◽  
Complicated Acute Appendicitis

Background and Objective: Acute appendicitis is one of the most common and at the same time lethal if not treated promptly. Failure to treat this medical condition in a timely manner then it can lead to major complications that endanger the patient’s health. In these cases, surgical treatment can be done in an open or laparoscopic method. Despite some limited studies comparing the results of these two therapies, there is still insufficient information in patients with this complicated situation. The aim of this study was to evaluate the results of these two therapies in patients with complicated acute appendicitis. Materials and Methods: In this randomized controlled clinical trial, 52 patients with complicated acute appendicitis in the laparoscopic surgery group and 56 patients in the open surgery group were studied. Primary outcomes in this study were duration of surgery and secondary outcomes including wound infection, intra-abdominal abscess, postoperative pain, miscarriage, hospitalization, and need for re-surgery that were compared between the two groups. Results: Both groups were matched for age (mean 31.0 years in laparoscopic surgery group, 30.5 years in open surgery group, p = 0.81) and gender (28 men in laparoscopic surgery group, 32 men in surgical group, p = 0.73). The mean duration of surgery in the laparoscopic group was significantly longer (mean 66.8 vs. 55.1 min, p <0.001). In contrast, mean duration of hospitalization (85.2 vs 98.6 hours, p <0.001) and mean postoperative pain severity (6.3 vs 7.2, p <0.001) was more significant high in open surgery group. In other cases there was no significant difference between the two groups. Conclusion: Although in surgical treatment of complicated acute appendicitis the duration of laparoscopic surgery is longer than the open method, but the duration of hospitalization and pain intensity in laparoscopic method is significantly reduced.

Comparison of Clinical Efficacy and Complications Between Laparoscopic Versus Open Surgery for Low Rectal Cancer

2019 ◽  
Vol 22 (3) ◽  
pp. 179-186 ◽  
Author(s):  
Jian Dai ◽  
Zhou Yu
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Blood Loss ◽  
Hospital Stay ◽  
Complication Rate ◽  
Open Surgery ◽  
Operation Time ◽  
Lower Rectal Cancer ◽  
Surgery Group ◽  
Stay Time

Aim: To compare the surgical outcomes of laparoscopic surgery for lower rectal cancer with open surgery. Methods: The multiple databases including PubMed, Springer, EMBASE, EMBASE, OVID were adopted to search for the relevant studies, and full-text articles involving the comparison of unilateral and bilateral PVP surgery were reviewed. Review Manager 5.0 was adopted to estimate the effects of the results among the selected articles. Forest plots, sensitivity analysis and bias analysis for the articles included were also conducted. Results: Finally, 1186 patients were included in the 10 studies, which eventually satisfied the eligibility criteria, and laparoscopic and open surgery group were 646 and 540, respectively. The meta-analysis suggested that there was no significant difference of the operation time between laparoscopic and open surgery group, while the time to solid intake, hospital stay time, blood loss and complication rate of laparoscopic group are much less than those of open surgery. Conclusion: Although both these two punctures provide similar operation time, we encourage the use of the laparoscopic surgery as the preferred surgical technique for treatment of lower rectal cancer due to less time to solid intake, hospital stay time, blood loss and lower complication rate.

Comparison of Laparoscopic and Open Surgery for Patients With Borderline Ovarian Tumors

2018 ◽  
Vol 28 (9) ◽  
pp. 1657-1663 ◽  
Author(s):  
Hee-Jung Jung ◽  
Jeong-Yeol Park ◽  
Dae-Yeon Kim ◽  
Dae-Shik Suh ◽  
Jong-Hyeok Kim ◽  
...  
Keyword(s):  
Overall Survival ◽  
Laparoscopic Surgery ◽  
Surgical Outcomes ◽  
Open Surgery ◽  
Disease Free Survival ◽  
Free Survival ◽  
Borderline Ovarian Tumors ◽  
Surgery Group ◽  
Significant Difference ◽  
Disease Free

ObjectivesThe aim of this study was to compare surgical and oncologic outcomes of open and laparoscopic surgery in patients with borderline ovarian tumors (BOTs).Materials and MethodsThis study included patients with BOTs who underwent open (n = 433) or laparoscopic (n = 210) surgery between 1990 and 2015. Surgical outcomes, perioperative morbidity, and disease-free survival and overall survival were compared.ResultsThere was no significant difference in age, histologic type of tumor, and laterality of tumor. However, body mass index was slightly higher for the open surgery group (P = 0.046). The open surgery group had a higher serum cancer antigen 125 level (P < 0.001), larger tumor size (P < 0.001), more frequent radical surgery (P = 0.001), higher stage (P = 0.034), and higher incidence of invasive implants (P = 0.035). The operative time (P < 0.001), time interval to return of bowel movement (P < 0.001), and length of postoperative hospital stay (P < 0.001) were significantly shorter and estimated blood loss was significantly less (P < 0.001) in the laparoscopic group. Perioperative complications were documented in 5 (2.4%) patients in the laparoscopic surgery group and 17 (3.9%) in the open surgery group (P = 0.064). Twenty-three (5.3%) patients in the open surgery group and 9 (4.3%) in the laparoscopic surgery group had recurrence (P = 0.902) at a median follow-up of 57 months. The 10-year disease-free survival was 96% and 97% for the open and laparoscopic groups, respectively (P = 0.851), with no significant difference between the groups after adjusting for independent factors (odds ratio, 1.0; 95% confidence interval, 0.4–2.4; P = 0.999). The 10-year overall survival was 99% for both groups, respectively (P = 0.441).ConclusionsLaparoscopic surgery and open surgery showed similar survival outcomes in BOTs. The surgical outcomes of laparoscopic surgery were more favorable.

scholarly journals Open versus Laparoscopic Inguinal Hernioplasty - Outcome Correlation

2017 ◽  
Vol 8 (1) ◽  
pp. 3-7
Author(s):  
Akhter Ahmed ◽  
Salma Yesmin Chowdhury ◽  
Md Mustafizur Rahman ◽  
Farhana Shimu ◽  
Shaon Shahriar ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Confidence Interval ◽  
Mesh Repair ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Open Group ◽  
Laparoscopic Technique ◽  
Percent Confidence Interval ◽  
Surgery Group ◽  
Inguinal Hernias

Background: Repair of inguinal hernias in men is a common surgical procedure, but the most effective surgical technique is still in debate.Methods: We randomly assigned men with inguinal hernias at Mitford Hospital surgery, ward to either open mesh or laparoscopic mesh repair. The primary aim was to detect recurrence of hernias in both groups at 6 month. Secondary aims were to detect complications and patient compliance.Results: of the 70 patients who were randomly assigned to one of the two procedures, 62 underwent operation; 6 month follow-up was completed in 55 (78.6%). Recurrences were only one in the laparoscopic group (3.6%) and 1 in the open group (3.7%). The rate of complications was lower in the laparoscopic-surgery group than in the open-surgery group (17.6% vs. 27%). The laparoscopic- surgery group had less pain initially than the open-surgery group on the day of surgery (difference in mean score on a visual-analogue scale, 10.2 mm; 95 percent confidence interval, 4.8 to 15.6) and at two weeks (6.1 mm; 95 percent confidence interval, 1.7 to 10.5) and returned to normal activities earlier (adjusted hazard ratio for a shorter time to return to normal activities, 1.2; 95% confidence interval, 1.1 to 1.3). Hospital stay was shorter in laparoscopic group (2.6 days vs 3.2 days). Patients’ satisfaction with surgery was 95% in the laparoscopic group and 87% in open group. Nenety six laparoscopic and 87% of open surgery patients perceived that they were healthy after surgery. Total treatment cost was more in laparoscopic group.Conclusions: The laparoscopic technique is superior to the open technique for mesh repair of primary hernias.J Shaheed Suhrawardy Med Coll, June 2016, Vol.8(1); 3-7

Effect of Carbon Nanoparticle Tracer Combined with Laparoscopy in the Treatment of Colon Cancer

2020 ◽  
Vol 20 (10) ◽  
pp. 6007-6012
Author(s):  
Liang Wang ◽  
Huaping Xu ◽  
Xiaofeng Zhang ◽  
Yisheng Zhang ◽  
Lianghui Shi ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Lymph Node ◽  
Laparoscopic Surgery ◽  
Postoperative Complications ◽  
Recovery Time ◽  
Open Surgery ◽  
Laparoscopic Group ◽  
Intraoperative Blood Loss ◽  
Node Dissection ◽  
Surgery Group

In this study, our aim was to compare the clinical effects of laparoscopic surgery and open surgery for the treatment of colon cancer. From January 2018 to December 2018, a random sample of 398 colon cancer patients was collected. The open abdominal surgery group underwent open surgery, while the laparoscopic surgery group underwent laparoscopic surgery. The success rate of the two groups, total intraoperative blood loss, length of incision, postoperative bedtime, times of lymph node dissection, and incidence of postoperative complications were compared. Both groups were provided carbon nanotracers for staining. The intraoperative blood loss of the laparoscopic group was significantly lower than that of the open abdominal group (this difference was statistically significant, P < 0.01). However, the operation time and lymph node dissection were similar for the laparoscopic group and the open abdominal group (the difference was not statistically significant, P > 0.05). The gastrointestinal function recovery time, hospital stay, and lung infection rate of patients in the laparoscopic group were significantly lower than those of patients in the open abdominal group. Postoperative bleeding, anastomotic leakage, and wound infection were also observed, but differences between the groups were not statistically significant. The incidence of postoperative complications in the laparoscopic surgery group was lower than that in the open surgery group (statistically significantly, P < 0.05). Laparoscopic surgery in patients with colon cancer is effective and offers patients improved health, shortened recovery time, and better quality of life. Carbon nanotracers can be used to stain lymph nodes and to make distinguishing between diseased and normal tissue easier.

scholarly journals Adequate lymphadenectomy for colorectal cancer: a comparative analysis between open and laparoscopic surgery

2015 ◽  
Vol 28 (2) ◽  
pp. 105-108
Author(s):  
Vilson Leite BATISTA ◽  
Antonio Carlos Ribeiro Garrido IGLESIAS ◽  
Fernando Athayde Veloso MADUREIRA ◽  
Anke BERGMANN ◽  
Rachel Perez DUARTE ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Lymph Nodes ◽  
Open Surgery ◽  
Tumor Stage ◽  
Disease Stage ◽  
Stage Number ◽  
Advanced Disease Stage ◽  
Degree Of Differentiation ◽  
To Receive

BACKGROUND: In the surgical treatment of colorectal cancer, a lymphadenectomy is considered adequate when at least 12 lymph nodes are removed. AIM: To evaluate whether videolaparoscopic surgery positively affects the rates of adequate lymphadenectomy. METHODS: An observational study was conducted with patients undergoing either open or videolaparoscopic surgery for colorectal cancer between 2008 and 2013. The following variables were collected: gender, age, tumor site, histology, degree of differentiation, tumor stage, number of lymph nodes removed, and number of lymph nodes affected by the disease. RESULTS: A total of 62 patients with colorectal cancer were included; 42 (67.7%) received open surgery, and 20 (32.3%) laparoscopic surgery. Regarding lymphadenectomy, a mean of 13 lymph nodes (95% CI: 10-16) were removed in the group that received open surgery, while 19 lymph nodes were removed (95% CI: 14-24) in the laparoscopic surgery group (p=0.021). Adequate lymphadenectomy (removal of at least 12 lymph nodes) was achieved in 58.1% of the total cases, in 50.0% of the patients who received open surgery, and in 75% of those who received laparoscopic surgery. Non-elderly patients and those with an advanced disease stage were more likely to receive an adequate lymphadenectomy (p=0.004 and p=0.035, respectively). CONCLUSION: Disease stage and patient age were the factors that had the greatest influence on achieving an adequate lymphadenectomy. The type of surgery did not affect the number of lymph nodes removed.

scholarly journals Decreasing Postoperative Pulmonary Complication Following Laparoscopic Surgery in Elderly Individuals with Colorectal Cancer: A Competing Risk Analysis in a Propensity Score–Weighted Cohort Study

Cancers ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 131
Author(s):  
Yih-Jong Chern ◽  
Jeng-Fu You ◽  
Ching-Chung Cheng ◽  
Jing-Rong Jhuang ◽  
Chien-Yuh Yeh ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Laparoscopic Surgery ◽  
Risk Analysis ◽  
Elderly Patients ◽  
Open Surgery ◽  
Competing Risk ◽  
Competing Risk Analysis ◽  
Long Term Outcomes ◽  
Laparoscopy Group

Advanced age is a risk factor for major abdominal surgery due to a decline in physical function and increased comorbidities. Although laparoscopic surgery provides good results in most patients with colorectal cancer (CRC), its effect on elderly patients remains unclear. This study aimed to compare the short- and long-term outcomes between open and laparoscopic surgeries in elderly patients with CRC. Total 1350 patients aged ≥75 years who underwent curative resection for stage I–III primary CRC were enrolled retrospectively and were divided into open surgery (846 patients) and laparoscopy (504 patients) groups. After propensity score weighting to balance an uneven distribution, a competing risk analysis was used to analyze the short-term and long-term outcomes. Postoperative mortality rates were lower in the laparoscopy group, especially due to pulmonary complications. Postoperative hospital stay was significantly shorter in the laparoscopy group than in the open surgery group. Overall survival, disease-free survival, and competing risk analysis showed no significant differences between the two groups. Laparoscopic surgery for elderly patients with CRC significantly decreased pulmonary-related postoperative morbidity and mortality in this large cohort study. Laparoscopic surgery is a favorable method for elderly patients with CRC than open surgery in terms of less hospital stay and similar oncological outcomes.

scholarly journals Standardized radical hysterectomy promises the clinical outcomes of laparoscopic surgery for early-stage cervical cancer

2020 ◽  
Author(s):  
Weihong Yang ◽  
Rong Chen ◽  
Caixia Li ◽  
Li Li ◽  
Ning Luo ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Clinical Outcomes ◽  
Radical Hysterectomy ◽  
Open Surgery ◽  
Early Stage ◽  
Disease Free Survival ◽  
Laparoscopy Group ◽  
Free Survival ◽  
Early Stage Cervical Cancer ◽  
Disease Free

Abstract Background: The recent publication of LACC Clinical Trial (NCT00614211) stated that minimally invasive radical hysterectomy was associated with lower rates of disease-free survival and overall survival than open abdominal radical hysterectomy among women with early-stage cervical cancer (ECC). The purpose of this present study is to evaluate clinical outcomes of laparoscopic standardized radical hysterectomy for ECC. Methods: This is a retrospective controlled study. 328 women with ECC (IA1, IA2, IB1 or IIA1) underwent primary surgery treatments by laparoscopy or laparotomy in Tenth’s People Hospitals. The women diagnosed as stage IB1 or IIA1 performed radical hysterectomy (RH). The total parametrium excision in process of radical hysterectomy was clarified specially in the study. Results: 186 patients underwent open surgery and 142 ones were performed laparoscopic surgery. Laparoscopic surgery was associated with less blood loss (194.43±84.40ml vs. 362.68±253.36ml, P<0.01), shorter hospital staying (11day vs. 14day, P<0.01) and fewer risk of blood transfusion (2.8% vs. 18.8%, P<0.01). There was no statistical difference in postoperative complications between two groups (18/142,12.7% vs. 21/186,11.3% P>0.05). The rate of 5-years overall survival (OS) was 92.8% in laparoscopy group similar to that of 94.4% in open group (p=0.762). Disease-free survival (DFS) rate at 3 years in laparoscopy group significantly decreased when compared to open group (91.8% vs 95.0%, p=0.030). But there was no difference in 3-years DFS among the women with tumor size <2cm (100% vs 97.0%, p=0.818). Discussion: Laparoscopic surgery was associated with preferable surgical quality compared to open surgery in ECC. Laparoscopic radical hysterectomy may be fit to the women with tumor <2cm. Standardized radical hysterectomy helps to promise the clinical outcomes of LRH in ECC.

Comparison of survival outcomes between laparoscopic and open surgery in patients with low-risk endometrial cancer

2020 ◽  
Vol 50 (11) ◽  
pp. 1261-1264
Author(s):  
Shinichi Togami ◽  
Toshihiko Kawamura ◽  
Shintaro Yanazume ◽  
Masaki Kamio ◽  
Hiroaki Kobayashi
Keyword(s):  
Overall Survival ◽  
Endometrial Cancer ◽  
Laparoscopic Surgery ◽  
Open Surgery ◽  
Low Risk ◽  
Recurrence Free Survival ◽  
Free Survival ◽  
Surgery Group ◽  
Gynecology And Obstetrics ◽  
Surgical Data

Abstract Objective To evaluate the feasibility, safety and surgical outcomes of laparoscopic surgery for the treatment of low-risk endometrial cancer. Methods Of 155 patients with low-risk endometrial cancer, who were included in this retrospective study between May 2008 and March 2017, 82 and 73 underwent laparoscopic and open surgery, respectively. Clinicopathological and surgical data, recurrence-free survival and overall survival were analyzed. Results No statistically significant differences in median age, final pathological type, International Federation of Gynecology and Obstetrics stage and lymphovascular space involvement were observed between the laparoscopic and open surgery groups. No procedure in the laparoscopic surgery group was converted to open surgery. The median follow-up period was 60 months, with oncologic recurrence identified in three cases (one lung carcinoma and two pelvic cavity carcinomas) in the laparoscopic surgery group. There was no significant between-group difference in 5-year recurrence-free survival (laparoscopic surgery group: 96.3%, open surgery group: 92.6%) and overall survival (laparoscopic surgery group: 100%, open surgery group: 95.4%). Conclusions Laparoscopic surgery is a feasible and safe treatment for endometrial cancer and should be considered as a standard treatment option for low-risk endometrial cancer.

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