Comparison between laparoscopy-assisted colectomy and open colectomy for prognosis in patients with sigmoid and rectosigmoid carcinoma

Purpose: The aim of this study was to compare the oncologic outcomes of laparoscopy-assisted colectomy (LAC) and open colectomy (OC) for colorectal cancer. Subjects: This retrospective, non-randomized study examined 88 patients who were cured with no residual tumors after undergoing a colorectal resection with a D3-dissection between January 1996 and March 2005. The patients were divided into 2 groups, those receiving a LAC (n = 43) and those receiving an OC (n = 45). The groups were compared with regard to blood loss, duration of surgery, lymph node yield, postoperative hospital stay, complications, recurrence, and survival rates. Results: None of the patients in the LAC group required conversion to OC in this study. Intraoperative blood loss was significantly lower for the LAC group (18mL) than for the OC group (271mL, P < 0.0001), and the postoperative hospital stay was significantly shorter for the LAC group (13 days) than for the OC group (25 days, P < 0.0001). The duration of surgery and the number of dissected lymph nodes were very similar between the groups. No significant differences in the rate of complication (LAC, 9.3% ; OC, 22.2% ; P = 0.0976), the recurrence rate (LAC, 2.3% ; OC, 11.1% ; P = 0.1022), the overall 5-year survival rate (LAC, 100% ; OC, 93.2% ; P = 0.1064) or the disease-free 5-year survival rate (LAC, 95.2% ; OC, 86.6% ; P = 0.1793) were observed between the groups. No perioperative deaths occurred in either group. Conclusions: Our findings suggest that LAC offers not only the better short-term prognosis but also a very similar oncologic outcomes to that of OC with regard to the middle-to-long-term prognosis for sigmoid and rectosigmoid carcinoma. We therefore expect that LAC could be equally effective as traditional OC for sigmoid and rectosigoid resection with D3-dissection from an oncologic point of view.