Comparison between laparoscopic and open surgery for colon cancer

The present study compares two surgical techniques for the treatment of colon cancer: Open Colectomy (OC) and Laparoscopic Assisted Colectomy (LAC). They found that LAC may be preferred to OC for removal of colon cancer.

The first treatment of choice for colon cancer which is localized to the colonic wall (has not spread to lymph nodes, blood system or other tissues) is surgical removal of the tumor. The conventional surgical technique is called open colectomy (OC). It is a surgical procedure to remove all or part of the colon through a lengthy incision in the abdominal wall. The alternative (minimally invasive) procedure, LAC, is done with the aid of a laparoscope. It involves making only several small incisions in the wall of the abdomen.

This report systematically compares the benefits and disadvantages of both procedures. It analyzes the data for 4616 patients who underwent surgeries in multiple medical centers during the last 20 years. 2170 patients underwent OC, and 2444 were operated laparoscopically.

LAC provided obvious short-term advantages for the patients. These include less blood loss, lower rate of post-operative complications, less pain, faster recovery and resumption of normal eating, and better quality of life. On the other hand, LAC involves significantly longer operative time. Both techniques equally succeeded in the complete removal of the tumor.

Importantly, the study demonstrates that LAC and OC provide similar post-operative survival and recurrence (return of the cancer) rates, reflecting the equal surgical efficiency of both methods.

On average, the combined costs of surgery and hospital stay were the same for both LAC and OC. But the exact cost varies significantly depending on country and complexity of individual case. Also, there is a significant variability in terms of individual outcome. The success of treatment depends on individual- and cancer-related features as well as the skills of the surgeon.

In summary, due to the similar survival benefits, but better recovery profile, the authors suggest that LAC may be a superior surgical technique for colon cancer.