Laparoscopic colectomy versus open colectomy for colorectal carcinoma: a retrospective analysis of patients followed up for at least 4 years.

摘要

PURPOSE. To compare the long-term outcome of laparoscopic-assisted colectomy (LAC) with that of open colectomy (OC) for carcinoma in patients followed up for a minimum of 4 years. METHODS. We reviewed the medical records of 118 patients who underwent LAC between January 1993 and September 1999, and compared the results with those of 163 selected patients who underwent OC during the same period. RESULTS. Curative surgery was performed in 114 of the LAC patients. Because recurrence did not develop in any of the patients with stage I cancer, we analyzed the patterns of recurrence only in those with stage II or III disease; 58 patients were analyzed in the laparoscopic group and 130 in the open colectomy group. In the LAC group, 7 (12.1%) patients had recurrence after a median follow-up of 58 months and in the OC group, 19 (14.6%) patients had recurrence after a median follow-up of 56.5 months. The 5-year disease-free rate was similar in the LAC (87.8%) and OC (85.5%) groups ( P = 0.75 by the log-rank test). CONCLUSIONS. Laparoscopic-assisted colectomy is effective and safe for the treatment of colorectal carcinomas under the criteria used in this study. However, further validation of these results is recommended.