The effect of laparoscopic surgery in stage II and III right-sided colon cancer: a retrospective study
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
The effect of laparoscopic surgery in stage II and III right-sided colon cancer: a retrospective study Bong-Hyeon Kye1, Jun-Gi Kim2*, Hyeon-Min Cho1, Jung Hwan Lee1, Hyung-Jin Kim1, Young-Jin Suh1 and Chung-Soo Chun1
Abstract Background: This retrospective study compared the clinicopathological results among three groups divided by time sequence to evaluate the impact of introducing laparoscopic surgery on long-term oncological outcomes for right-sided colon cancer. Methods: From April 1986 to December 2006, 200 patients who underwent elective surgery with stage II and III right-sided colon cancer were analyzed. The period for group I referred back to the time when laparoscopic approach had not yet been introduced. The period for group II was designated as the time when first laparoscopic approach for right colectomy was carried out until we overcame its learning curve. The period for group III was the period after overcoming this learning curve. Results: When groups I and II, and groups II and III were compared, overall survival (OS) did not differ significantly whereas disease-free survival (DFS) in groups I and III were statistically higher than in group II (P = 0.042 and P = 0.050). In group III, laparoscopic surgery had a tendency to provide better long-term OS (P = 0.2036) and DFS (P = 0.2356) than open surgery. Also, the incidence of local recurrence in group III (2.6%) was significantly lower than that in groups II (7.4%) and I (12.1%) (P = 0.013). Conclusions: Institutions should standardize their techniques and then provide fellowship training for newcomers of laparoscopic colon cancer surgery. This technique once mastered will become the gold standard approach to colon surgery as it is both safe and feasible considering the oncological and technical aspects. Keywords: Laparoscopic surgery, Learning curve, Long-term outcome, Right sided colon cancer
Background Colorectal cancer, the second most common cancer in Korea, has been increasing exponentially probably due to Westernized dietary habits. After the first laparoscopic colon resection was reported by Jacobs et al. [1] in 1991 many articles were published about the feasibility of laparoscopic surgery. Then, numerous articles acclaimed laparoscopic surgery for its short-term benefits despite the long operation time. Recently, articles from multicenter trials suggested that long-term outcome of laparoscopic surgery was not inferior to that of open surgery [2-5]. Although many data are yet to be statistically validated, results tend to show that advantages of laparoscopic surgery outweigh * Correspondence: [email protected] 2 Seoul St. Mary’s Hospital, Department of Surgery, College of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seoul, Seocho-gu 137-701 South Korea Full list of author information is available at the end of the article
those of open surgery [6-8]. It is imperative to overcome the learning curve (LC) of laparoscopic surgery but once conquered, laparoscopic surg
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