Laparoscopic removal of the gallbla...

Laparoscopic removal of the gallbladder is widely make use ofed yet the extension of laparoscopic approaches to other intra-abdominal surgeries has been slower. An early surgical case series reported be of importance tos about increased cancer recurrence after laparoscopic removal of colon cancer. The Clinical consequences of Surgical Therapy Study arrange presents long-term follow-up data upon a trial of laparoscopic versus interpret colectomy in patients with colon cancer.

This large multicenter reflection enrolled adults with adenocarcinoma of the colon excluding those with bitter abdominal adhesions, advanced local or metastatic disease, rectal or transverse colon cancer, inflammatory bowel disease, attendant cancer, and other severe medical illness. Participants were randomized to laparoscopic or explain colectomy. However, 21 percent of patients randomized to a laparoscopic technique had to be changeed to open colectomy at the time of surgery

completed follow-up data after four years were available for 98 percent of trial participants. Laparoscopic removal of the colon required a longer average operating time (150 minutes) compared with an expand approach (95 minutes). Surgical margins and the number of lymph nodes examined were similar between the sum of two units techniques. Intraoperative complications occurred in 4 percent of laparoscopic cases and 2 percent of unclose surgeries, which was not a statistically significant difference.

throughout a median follow-up period of 44 years, the rate of tumor the having recourse was not significantly different between laparoscopic colectomy and interpret colonic resection (16 versus 18 percent) Overall survival rates and disease-free survival also were similar, and this finding held real for all stages of colon cancer. Tumor return at the site of surgical injurys was uncommon; rates were similar between collections (0.5 in the laparoscopy clump compared with 0.2 percent in the open-surgery group) Postoperative redemption was quicker in the laparoscopic cluster with a shorter hospital stay (median, five versus six days) and briefer use of parenteral narcotics (median, three versus four days). Short-term postoperative mortality, and rates of readmission and re-operation were similar for the couple techniques.

The investigation group concludes that laparoscopic colectomy is at least as effective as a standard interpret technique with respect to rates of operative complications, tumor return and overall survival. Laparoscopic removal of the colon requires longer operating times on the contrary is associated with quicker postoperative recovery

The Clinical results of Surgical Therapy Study form into groups A comparison of laparoscopically assisted and expand colectomy for colon cancer. N Engl J M May 13 2004;350:2050-9

COPYRIGHT 2005 American Academy of Family Physicians

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