Superior Lymph Node Resection is Achievable with Laparoscopic Colectomy: Even in Initial 30 Cases

Abstract

Recent studies demonstrated the validity of the laparoscopic technique in colon cancer resection. Recent node resection data for open colectomies show inadequate nodal removal is common. In this study, two experienced laparoscopic surgeons evaluated their initial outcomes with laparoscopic colectomy, including resections for malignancies. This retrospective review of clinic and hospital records involved 69 consecutive patients subjected to laparoscopic colectomies from July 2000 through December 2005. Outcomes were compared with 1000 patients from Senagore and Delaney. Adequacy of oncologic resection was compared with the published National Cancer Institute database. Sixty-nine resections were performed. Overall complication and conversion rates were comparable to Senagore and Delaney except for days of hospitalization at 6.0 compared with 3.7 (P < 0.01) and readmission of 4.2 per cent compared with 9.1 per cent (P < 0.01). Adequate node resection occurred in 26 of 32 patients (81%) compared with 37 per cent of open colectomies in the National Cancer Institute nationwide database (P < 0.05). The overall median number of nodes resected was 18. For veteran laparoscopic surgeons in a community hospital, the initial experience with laparoscopic colectomy can provide excellent results, meeting standards set in large published series. In addition, the resection of nodes in colon cancer can be significantly better when performed laparoscopically or by hand-assisted laparoscopy.