The safety and short-term benefits of laparoscopic colectomy for cancer remain debatable.
The multicenter COLOR (COlon cancer Laparoscopic or Open Resection) trial was designed by Professor Jaap Bonjer and colleagues from Canada.
The team assessed the safety of laparoscopic resection compared with open resection for curative treatment of patients with cancer of the right or left colon.
|Laparoscopic colectomy leads to earlier recovery of bowel function|
The researchers randomly assigned 627 patients to laparoscopic surgery and 621 patients to open surgery.
The primary endpoint was cancer-free survival 3 years after surgery.
The researchers considered secondary outcomes including short-term morbidity and mortality, number of positive resection margins, and local recurrence.
The team also assessed port-site or wound-site recurrence, metastasis, overall survival, and blood loss during surgery.
The researchers conducted analysis by intention to treat.
The team found that patients assigned laparoscopic resection had less blood loss compared with those assigned open resection.
The researchers noted, however, that laparoscopic surgery lasted 30 min longer than did open surgery.
Conversion to open surgery was needed for 91 patients undergoing the laparoscopic procedure.
The team assessed radicality of resection by number of removed lymph nodes and length of resected oral and aboral bowel did not differ between groups.
The research team noted an association between laparoscopic colectomy and earlier recovery of bowel function.
There was also an association between laparoscopic colectomy and the need for fewer analgesics, and with a shorter hospital stay compared with open colectomy.
In addition, the team observed that morbidity and mortality 28 days after colectomy did not differ between groups.
Professor Bonjer's team concludes, “Laparoscopic surgery can be used for safe and radical resection of cancer in the right, left, and sigmoid colon.”