Ten-year outcomes following laparoscopic colorectal resection: results of a randomized controlled trial

Nicolò Pecorelli, Salvatore Amodeo, Matteo Frasson, Andrea Vignali, Walter Zuliani, Marco Braga

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the impact of laparoscopy compared to open surgery on long-term outcomes in a large series of patients who participated in a randomized controlled trial comparing short-term results of laparoscopic (LPS) versus open colorectal resection. Methods: This is a retrospective review of a prospective database including 662 patients with colorectal disease (526, 79 % cancer patients) who were randomly assigned to LPS or open colorectal resection and followed every 6 months by office visits. The primary endpoint of the study was long-term morbidity. Secondary outcomes included 10-year overall, cancer-specific, and disease-free survivals. All patients were analyzed on an intention-to-treat basis. Results: Fifty-eight (8.8 %) patients were lost to follow-up. Median follow-up was 131 (IQR 78–153) months in the LPS group and 126 (IQR 52–152) months in the open group (p = 0.121). Overall, long-term morbidity rate was 11.8 % (36/309) in the LPS versus 12.6 % (37/295) in the open group (p = 0.770). Incisional hernia rate was 5.8 % (18/309) in the LPS group versus 8.1 % (24/295) in the open group (p = 0.264). Adhesion-related small-bowel obstruction occurred in five (1.6 %) patients in the LPS versus four (1.4 %) patients in the open group (p = 1.000). In 497 cancer patients, 10-year overall survival was 45.3 % in the LPS group and 40.9 % in the open group (p = 0.160). No difference was found in cancer-specific and disease-free survivals, also when patients were stratified according to cancer stage. Conclusion: In this series, LPS colorectal resection was not associated with a lower long-term morbidity rate when compared to open surgery. Overall, cancer-specific and disease-free survivals were similar in cancer patients who were treated with LPS and open surgeries.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalInternational Journal of Colorectal Disease
DOIs
Publication statusAccepted/In press - Apr 18 2016

Keywords

  • Colon cancer
  • Laparoscopy
  • Postoperative complications
  • Survival analysis
  • Ventral hernia

ASJC Scopus subject areas

  • Gastroenterology

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