COLORECTAL CANCER - COMPARISON OF LAPAROSCOPIC WITH OPEN APPROACHES

PURPOSE: We compared laparoscopic with open colectomy for treatment of colorectal cancer. METHODS: We performed a retrospective review of pa tients undergoing colectomy for colorectal cancer between January 1991 and March 1996 at a large private metropolitan teaching hospital. Ope rative techniques included open (n = 90) and laparoscopic (n = SO) col ectomy. Laparoscopic colectomy was further subdivided into the followi ng groups: facilitated (n = 62), with extracorporeal anastomosis; near -complete (n = 9), with small incision for specimen delivery only comp lete (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 hospit alization, morbidity,, lymph node yield, recurrence, survival, and cos ts. RESULTS: Operative time was equivalent in the laparoscopic and ope n groups (laparoscopic, 161 minutes; open, 163 minutes. P = 0.94). Blo od loss was less for the laparoscopic group (laparoscopic, 104 ml; ope n, 184 ml; P = 0.001), and resumption of oral intake was earlier (lapa roscopic, 3.9 days; open, 4.9 days; P = 0.001), but length of hospital ization was similar. Mean lymph node yield in the laparoscopic group w as 12 compared with IG in the open group (P = 0.16). Rates of morbidit y, recurrence, and survival were similar in both groups. No port-site recurrences occurred. CONCLUSIONS: Laparoscopic and open colectomy wer e 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 resum ption of oral intake.