One of the greatest advances in abdominal surgery in the past decade is the advent of laparoscopic colon resections. Minimally invasive resections were introduced in the 1990s for benign disease; in 2003 they were proven to be of equal oncologic benefit for colon cancer when compared to their open surgery counterpart. Studies have confirmed the five-year survival and local recurrence rates for laparoscopic and open or traditional surgical methods are very similar, and today the laparoscopic technique is an established treatment for colorectal cancer.
In May 2011, a retrospective cohort study published in the Archives of Surgery stated: “Laparoscopy independently predicts decreased mortality from colon resection even when controlling for multiple factors.”
The study compared mortality rate and associated factors for laparoscopic and open colectomy, using the Nationwide Inpatient Sample database. In the United States, an estimated 1,314,696 patients included in the Nationwide Inpatient Sample underwent colectomy between 2002 and 2007. Of these patients, 1,231,184 underwent open procedures and 83,512 had colectomy by a laparoscopic approach.
Study authors Molly M. Cone, M.D., of the Oregon Health and Science University Department of Surgery in Portland, and colleagues concluded: “Laparoscopic colectomy was shown to be an independent predictor of a markedly decreased mortality rate when compared with open colectomy.”
A study posted in the Annals of Surgery in 2010 concluded that laparoscopic resection for treatment of colorectal cancer can achieve excellent results, even in high-risk patients. The study also confirmed what we’ve experienced in our local practice: Laparoscopic colorectal surgery produces better outcomes for high-risk cancer patients compared to open surgery.
Unfortunately, despite strong evidence, less than 10 percent of colon resections across the country are performed in the minimally invasive fashion. Premier surgeons were early adopters of laparoscopic surgery in Knoxville and now routinely utilize this technique in most patients requiring colectomies.
The American Cancer Society offers this advice to patients exploring surgical options for the procedure: “Laparoscopic-assisted surgery is as likely to be curative as the open approach for colon cancers. But the surgery requires special expertise. If you are considering this approach, be sure to look for a skilled surgeon who has done many of these operations.”
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