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Thursday, May 13, 2004The biggest comparison of the two procedures to date, involving 48 U.S. and Canadian hospitals, found the same rates of survival, tumor recurrence and surgical complications. In addition, patients who had laparoscopic surgery had less pain and less time in the hospital. Experts predicted the results will end the virtual moratorium on such surgery that began in 1994. The study appears to be a well-designed one. It compared outcomes among a diversity of hospitals and surgeons. Participating surgeons had to submit a videotape of their performance to ensure that they all knew what they were doing. And the patients in both groups shared the same characteristics - same sex distribution, and the same diversity of types of tumors. There were a few differences in the outcomes, though: Operating times were significantly longer in the laparoscopic-surgery group than the open-colectomy group (150 minutes vs. 95 minutes, P<0.001). Patients in the open-colectomy group were more likely than those in the laparoscopic-surgery group to undergo concurrent resection of other organs (63 vs. 34 patients, P=0.001); malignant histologic findings were identified in these resected organs in 14 patients in the open-colectomy group, as compared with 6 in the laparoscopic-surgery group. Abdominal-wall adhesions (P=0.002) and bowel adhesions (P=0.001) were reported more frequently among patients in the laparoscopic-surgery group. The laparoscopic group spent one day less in the hospital and used both intravenous and oral pain medication on average one day less than the open resection patients. There were more complications during surgery for the laparoscopic patients (4%) than the open resection patients (2%). Those complications included things like puncturing the bowel accidently or the spleen. But overall survival and cancer recurrence were about the same in both groups. So, will this replace open colon resection for colon cancer? Maybe in a few years, when surgeons learn the technique. Although, I've got to think that some of them will be reluctant to give up touching the bowel to look for other tumors that might have been missed pre-operatively. posted by Sydney on 5/13/2004 09:29:00 AM 0 comments 0 Comments: |
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