Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution
1
Department of General Surgery, Chi Mei Medical Center, Liouying 73657, Taiwan
2
Department of General Surgery, Chi Mei Medical Center, Tainan 71004, Taiwan
3
Department of Electrical Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
4
Department of Cancer Center, Chi Mei Medical Center, Liouying 73657, Taiwan
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Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Department of Business Management, National Sun Yat Sen University, Kaohsiung 80424, Taiwan
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Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80708, Taiwan
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Department of Emergency Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan
9
Department of Senior Services, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
10
Department of Gastroenterology and Hepatology, Chi Mei Medical Center, Liouying 73657, Taiwan
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Department of Occupational Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan
12
Department of Occupational Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan
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Department of Leisure, Recreation and Tourism Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
14
Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan
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Department of Oncology, Chi Mei Medical Center, Liouying 73657, Taiwan
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National Institute of Cancer Research, National Health Research Institutes, Tainan 70403, Taiwan
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Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan
18
AI Biomed Center, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(6), 875; https://doi.org/10.3390/jcm8060875
Received: 30 April 2019 / Revised: 12 June 2019 / Accepted: 17 June 2019 / Published: 19 June 2019
(This article belongs to the Special Issue Clinical Medicine for Healthcare and Sustainability)
The oncologic merits of the laparoscopic technique for colorectal cancer surgery remain debatable. Eligible patients with non-metastatic colorectal cancer who were scheduled for an elective resection by one surgeon in a medical institution were randomized to either laparoscopic or open surgery. During this period, a total of 188 patients received laparoscopic surgery and the other 163 patients received the open approach. The primary endpoint was cancer-free five-year survival after operative treatment, and the secondary endpoint was the tumor recurrence incidence. Besides, surgical complications were also compared. There was no statistically significant difference between open and laparoscopic groups regarding the average number of lymph nodes dissected, ileus, anastomosis leakage, overall mortality rate, cancer recurrence rate, or cancer-free five-year survival. Even though performing a laparoscopic approach used a significantly longer operation time, this technique was more effective for colorectal cancer treatment in terms of shorter hospital stay and less blood loss. Meanwhile, fewer patients receiving the laparoscopic approach developed postoperative urinary tract infection, wound infection, or pneumonia, which reached statistical significance. For non-metastatic colorectal cancer patients, laparoscopic surgery resulted in better short-term outcomes, whether in several surgical complications and intra-operative blood loss. Though there was no significant statistical difference in terms of cancer-free five-year survival and tumor recurrence, it is strongly recommended that patients undergo laparoscopic surgery if not contraindicated.
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Keywords:
laparoscopic; open surgery; non-metastatic colorectal cancer; surgical complication; oncologic outcome; single surgeon experience
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MDPI and ACS Style
Chiu, C.-C.; Lin, W.-L.; Shi, H.-Y.; Huang, C.-C.; Chen, J.-J.; Su, S.-B.; Lai, C.-C.; Chao, C.-M.; Tsao, C.-J.; Chen, S.-H.; Wang, J.-J. Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution. J. Clin. Med. 2019, 8, 875. https://doi.org/10.3390/jcm8060875
AMA Style
Chiu C-C, Lin W-L, Shi H-Y, Huang C-C, Chen J-J, Su S-B, Lai C-C, Chao C-M, Tsao C-J, Chen S-H, Wang J-J. Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution. Journal of Clinical Medicine. 2019; 8(6):875. https://doi.org/10.3390/jcm8060875
Chicago/Turabian StyleChiu, Chong-Chi; Lin, Wen-Li; Shi, Hon-Yi; Huang, Chien-Cheng; Chen, Jyh-Jou; Su, Shih-Bin; Lai, Chih-Cheng; Chao, Chien-Ming; Tsao, Chao-Jung; Chen, Shang-Hung; Wang, Jhi-Joung. 2019. "Comparison of Oncologic Outcomes in Laparoscopic versus Open Surgery for Non-Metastatic Colorectal Cancer: Personal Experience in a Single Institution" J. Clin. Med. 8, no. 6: 875. https://doi.org/10.3390/jcm8060875
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