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Long-term oncologic outcomes of laparoscopic versus open resection following stent insertion for obstructing colon cancer: a multi-center retrospective study

Authors
 Sung Uk Bae  ;  Chun-Seok Yang  ;  Sohyun Kim  ;  Dae Ro Lim  ;  Woon Kyung Jeong  ;  Dae Dong Kim  ;  Jae Hwang Kim  ;  Eung Jin Shin  ;  Yoo Jin Lee  ;  Ju Yup Lee  ;  Nam Kyu Kim  ;  Seong Kyu Baek 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.33(12) : 3937-3944, 2019 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2019
Keywords
Colonic neoplasm ; Laparoscopy ; Outcome ; Stent
Abstract
BACKGROUND: This study compared oncologic outcomes between open and laparoscopic surgery following self-expanding metallic stents insertion for obstructing colon cancer.

METHODS: This retrospective study included 50 patients who underwent open surgery and 44 patients who underwent laparoscopic surgery for obstructing left-sided colon cancer at four tertiary referral hospitals between June 2005 and December 2013.

RESULTS: The median follow-up periods were 48 months and 47 months in the open and laparoscopic groups, respectively. The median operative time, time to soft diet, and length of stay were comparable between the groups. Four cases converted to open surgery (9.1%) in the laparoscopic group. The morbidity within 30 days after surgery was comparable between the groups (OR 0.931; 95% CI 0.357-2.426; p = 0.884). The proximal and distal resection margins, the histologic grade of tumor, TNM stage, median tumor size, and presence of lymphovascular invasion did not differ significantly between the groups. The 5-year overall survival (OS) rates of the open and laparoscopic groups were 67.1% and 71.7% (HR 1.028, 95% CI 0.491-2.15, p = 0.942) and the 5-year disease-free survival (DFS) rates were 55.8% and 61.5% (HR 0.982; 95% CI 0.522-1.847; p = 0.955), respectively. The recurrence pattern did not differ between the groups. Multivariate analysis showed that sex (p = 0.027), nodal stage (p = 0.043), and the proportion of patients receiving postoperative adjuvant chemotherapy (p = 0.002) were independent prognostic factors for OS. The proportion of patients receiving postoperative adjuvant chemotherapy (p = 0.017) was an independent prognostic factor for DFS.

CONCLUSIONS: Laparoscopic resection following stent insertion for obstructing colon cancer can be performed safely, with long-term oncologic outcomes comparable with those of open surgery.
Full Text
https://link.springer.com/article/10.1007%2Fs00464-019-06680-7
DOI
10.1007/s00464-019-06680-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Bae, Sung Uk(배성욱)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173441
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