Survival following laparoscopic and open colorectal surgery

Surg Endosc. 2013 Jul;27(7):2415-21. doi: 10.1007/s00464-012-2750-1. Epub 2013 Feb 8.


Background: Laparoscopic colorectal surgery is known to provide increased benefits to patients during the postoperative recovery period. Initial scepticism over the oncological adequacy of resection has been dismissed by a number of major randomized trials. Emerging evidence indicates that laparoscopic surgery may provide a potential survival benefit in colorectal cancer.

Methods: Patients undergoing elective laparoscopic or open resection for colorectal cancer between October 2003 and December 2010 were analyzed. Data were collated and a database compiled. Survival analysis was calculated by using the Kaplan-Meier method.

Results: A total of 665 resections were performed with 457 laparoscopically and 208 open. The median length of stay was 4 days following laparoscopic resection and 7 days following open (p < 0.0005). There was no significant difference between the two groups apart from gender (p = 0.03), ASA (p = 0.03), and the number of patients with extranodal metastatic disease (p = 0.01). The 5-year overall survival (OS) in the completed laparoscopic group was 75.8 versus 72.5 % in the open group (p = 0.12). The 5-year OS in patients who were converted was 52 %. The 5-year OS for nonmetastatic disease in the completed laparoscopic group was significantly greater at 79.4 versus 74 % in the open group (p = 0.03). There was no difference between the groups in OS for rectal cancer (p = 0.66), but there was an OS advantage for laparoscopically resected colon cancer (p = 0.02).

Conclusions: Laparoscopic resection for nonmetastatic colon cancer may provide an overall survival advantage.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Colectomy / methods
  • Colectomy / statistics & numerical data
  • Colorectal Neoplasms / mortality*
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy / mortality*
  • Length of Stay
  • Lymphatic Metastasis
  • Male
  • Retrospective Studies
  • Sex Factors