A single institutional experience in laparoscopic colorectal surgery: clinical and oncological outcomes over 10 years

Aleksandar Đermanović; Zoran Radovanović; Dejan Lukić; Mladen Đurić; Danica Golijanin; Milan Ranisavljević; Nemanja Petrović

doi:10.2298/AOO200728006D

Aleksandar Đermanović Oncology Institute of Vojvodina, Department of Surgical Oncology, Put Dr Goldmana 4, 21204 Sremska Kamenica
Zoran Radovanović Oncology Institute of Vojvodina, Department of Surgical Oncology, Put Dr Goldmana 4, 21204 Sremska Kamenica; University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, 21000 Novi Sad https://orcid.org/0000-0002-9609-195X
Dejan Lukić Oncology Institute of Vojvodina, Department of Surgical Oncology, Put Dr Goldmana 4, 21204 Sremska Kamenica; University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, 21000 Novi Sad https://orcid.org/0000-0003-3742-4774
Mladen Đurić Oncology Institute of Vojvodina https://orcid.org/0000-0002-8337-6534
Danica Golijanin Oncology Institute of Vojvodina https://orcid.org/0000-0001-7282-1893
Milan Ranisavljević Oncology Institute of Vojvodina, Department of Surgical Oncology, Put Dr Goldmana 4, 21204 Sremska Kamenica; University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, 21000 Novi Sad
Nemanja Petrović Oncology Institute of Vojvodina, Department of Medical Oncology, Put Dr Goldmana 4, 21204 Sremska Kamenica; University of Novi Sad, Faculty of Medicine, Hajduk Veljkova 3, 21000 Novi Sad

DOI: https://doi.org/10.2298/AOO200728006D

Keywords: laparoscopic colorectal surgery, colorectal cancer, surgical oncology

Abstract

ABSTRACT

Introduction: The development of laparoscopic colorectal surgery began in 1991. Today, laparoscopic surgery presents standard approach in the surgical treatment of malignant colon and rectal diseases.

Aim: Outcomes and survival rates of laparoscopic colorectal surgery at the Oncology Institute of Vojvodina.

Methods: Data were collected prospectively from 66 patients undergoing laparoscopic colorectal surgery between December 2009 and December 2019. Registered data included sex, age, surgical indication and type for the procedure, indication and reason for conversion to open surgery, operative time, performing temporary or permanent stoma, intraoperative bowel perforation , pathologic TNM grade, number of harvested lymph nodes, inclusion of positive resection margin, number of postoperative days at the hospital, postoperative complications, postoperative mortality, presence of distant metastases and survival rates.

Results: The procedures performed by the laparoscopic method were right hemicolectomy in 11/66 (16.7%) patients, left hemicolectomy in 1/66 (1.5%), sigmoid colectomy in 19/66 (28.8%) patients, high anterior rectal resection in 13/66 (19.7%), low anterior rectal resection in 12/66 (18.2%), abdominoperineal amputation of the rectum in 7/66 (10.6%), colectomy in 2/66 (3%) and proctocolectomy in 1/66 (1.5%) patient. The median follow-up was 37.5 months (range 6 to 128). The total number of surviving patients was 60 (90.9%).

Conclusion: This study showed that laparoscopic colorectal surgery has good clinical and oncological outcomes.

References

Gunnung J. The history of laparoscopy. J Reprod Med. 1974 Jun;12(6):222-6.

Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc. 1991;1(3):144-150

Fowler D, White S. Laparoscopy-assisted sigmoid resection. Surgical Laparoscopy Endoscopy. 1991;1(3):183–188

Phillips E, Franklin M, Carrol B, Fallas M, Ramos R, Rosenthal D. Laparoscopie Colectomy. Annals of Surgery. 1992;216(6):703-710.

Plasencia G, Jacobs M, Verdeja J, Viamonte M. Laparoscopic-assisted sigmoid colectomy and low anterior resection. Diseases of the Colon & Rectum. 1994;37(8):829-833.

Faiz O, Warusavitarne J, Bottle A, Tekkis P, Darzi A, Kennedy R. Laparoscopically Assisted vs. Open Elective Colonic and Rectal Resection: A Comparison of Outcomes in English National Health Service Trusts Between 1996 and 2006. Diseases of the Colon & Rectum. 2009;52(10):1695-1704.

Franklin M, Rosenthal D, Abrego-Medina D, Dorman J, Glass J, Norem R, et al. Prospective comparison of open vs. laparoscopic colon surgery for carcinoma. Diseases of the Colon & Rectum. 1996;39(Sup 1):S35-S46.

Köckerling F, Reymond M, Schneider C, Wittekind C, Scheidbach H, Konradt J, et al. Prospective multicenter study of the quality of oncologic resections in patients undergoing laparoscopic colorectal surgery for cancer. Diseases of the Colon & Rectum. 1998;41(8):963-970.

Tomita H, Marcello P, Milsom J. Laparoscopic Surgery of the Colon and Rectum. World Journal of Surgery. 1999;23(4):397-405.

Nelson H. Laparoscopically assisted colectomy is as safe and effective as open colectomy in people with colon cancer. Cancer Treatment Reviews. 2004;30(8):707-709.

Jayne D, Guillou P, Thorpe H, Quirke P, Copeland J, Smith A, et al. Randomized Trial of Laparoscopic-Assisted Resection of Colorectal Carcinoma: 3-Year Results of the UK MRC CLASICC Trial Group. Journal of Clinical Oncology. 2007;25(21):3061-3068.

Kuhry E, Schwenk W, Gaupset R, Romild U, Bonjer H. Long-term results of laparoscopic colorectal cancer resection. Cochrane Database of Systematic Reviews. 2008.

Panis Y, Maggiori L, Caranhac G, Bretagnol F, Vicaut E. Mortality After Colorectal Cancer Surgery. Annals of Surgery. 2011;254(5):738-744.

D'Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, et al. Robotic and Laparoscopic Surgery for Treatment of Colorectal Diseases. Diseases of the Colon & Rectum. 2004;47(12):2162-2168.

Harr J, Haskins I, Amdur R, Agarwal S, Obias V. The effect of obesity on laparoscopic and robotic-assisted colorectal surgery outcomes: an ACS-NSQIP database analysis. Journal of Robotic Surgery. 2017;12(2):317-323.

Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. The Lancet Oncology. 2009;10(1):44-52.

Fujii S, Tsukamoto M, Fukushima Y, Shimada R, Okamoto K, Tsuchiya T, et al. Systematic review of laparoscopic vs open surgery for colorectal cancer in elderly patients. World Journal of Gastrointestinal Oncology. 2016;8(7):573.

Daher R. New trends in colorectal surgery: Single port and natural orifice techniques. World Journal of Gastroenterology. 2014;20(48):18104.

Yang I, Boushey R, Marcello P. Hand-assisted laparoscopic colorectal surgery. Techniques in Coloproctology. 2013;17(S1):23-27.

Addison P, Agnew J, Martz J. Robotic Colorectal Surgery. Surgical Clinics of North America. 2020;100(2):337-360.

Zerey M, Hawver L, Awad Z, Stefanidis D, Richardson W, Fanelli R. SAGES evidence-based guidelines for the laparoscopic resection of curable colon and rectal cancer. Surgical Endoscopy. 2012;27(1):1-10.

Hajibandeh S, Hajibandeh S, Navid A, Sarma D, Eltair M, Mankotia R, et al. Meta-analysis of medial-to-lateral versus lateral-to-medial colorectal mobilisation during laparoscopic colorectal surgery. International Journal of Colorectal Disease. 2019;34(5):787-799.

Braga M, Vignali A, Zuliani W, Radaelli G, Gianotti L, Toussoun G, et al. Training period in laparoscopic colorectal surgery. Surgical Endoscopy And Other Interventional Techniques. 2001;16(1):31-35.

Dowson H, Cowie A, Ballard K, Gage H, Rockall T. Systematic review of quality of life following laparoscopic and open colorectal surgery. Colorectal Disease. 2008;10(8):757-768.

Coleman M, Rockall T. Formación en cirugía laparoscópica colorrectal. El modelo Lapco. Cirugía Española. 2013;91(5):279-280.

[Internet]. 2020 [cited 17 May 2020]. Available from: http:// www.clinicalaudit.nl/jaarrapportage/2014/assets/uploads/DICAJAAR-OFFLINE-2014.pdf

[Internet]. 2020 [cited 17 May 2020]. Available from: http://heelkunde.nl/sites/heelkunde.nl/files/ Eindtermen-differentiatiejaar-v3.0%281%29.pdf

de'Angelis N, Abdalla S, Bianchi G, Memeo R, Charpy C, Petrucciani N, et al. Robotic Versus Laparoscopic Colorectal Cancer Surgery in Elderly Patients: A Propensity Score Match Analysis. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2018;28(11):1334-1345.