Does laparoscopic surgery reduce the risk of developing desmoid tumors?

The authors compared the risk of developing desmoid tumors, following laparoscopic or open surgery, in patients with familial adenomatous polyposis.

Familial adenomatous polyposis is an inherited disease involving cancer of the large intestine and rectum. Patients are at increased risk of developing desmoid tumors (noncancerous growths that usually occur in the tissue covering the intestines, or in the abdomen).

Understanding the cause of desmoid tumor growth in patients is important, as they are the primary cause of death after colectomy (procedure to remove all or part of the large intestine). As they often grow in surgical scars it is suggested that trauma during surgery may be involved in their growth. 

In this study the authors examined whether laparoscopic surgery (a modern technique which involves very small incisions) was safer than open surgery (original technique where a large incision is made).

The authors included 672 patients with familial adenomatous polyposis. These patients had no history of desmoid tumors before receiving prophylactic surgery (preventative surgery). They were separated into two groups. One group received laparoscopic surgery (70 patients), the other group received open surgery (602 patients). The average follow-up time was 60 months after laparoscopic surgery and 132 months after open surgery. After open surgery 16% of patients developed desmoid tumors, compared to only 4% of patients after laparoscopic surgery.  In other words, the patients who received open surgery had 6.84 times the risk of developing desmoid tumors. The authors also reported that females had 2.18 times the risk of developing desmoid tumors.

The authors concluded that laparoscopic surgery reduced the risk of developing desmoid tumors after preventative surgery.

There was a large difference in the size of the groups and average follow up time. This may have influenced the results.