Comparison of laparoscopic and traditional multivisceral resections in locally advanced colorectal cancer



Introduction. The feasibility of the application of laparoscopic surgery in treatment of locally advanced colorectal cancer remains controversial. The aim of our study was to evaluate the safety and efficacy of laparoscopic multivisceral resections for cancer of the colon and rectum.

Materials and methods. The study included 86 patients with T4b tumors of colon and rectum operated from 2013 to 2015. Patients were divided into two groups – 42 into laparoscopic group and 44 into open.

Results. The following miniinvasive procedures were performed: 11 patients underwent laparoscopic resection of primary tumor, combined with hysterectomy (posterior pelvic exenteration), 2 – with liver resections, 8 – with salpingo-oophorectomy, 5 – with small intestine resection, 2 – with splenectomy, 3 – with gastric resection, 2 – with resection of the ureter, 2 – with nephrectomy, 5 – with bladder resection, 3 patients underwent laparoscopic total pelvic exenteration. The average amount of blood loss in laparoscopic group – 205 ml, in open group – 480 ml. Mean operative time was 201 and 150 minutes. Resections within the negative margins were performed in 38 patients in laparoscopic group and 37 in the open group. The average number of lymph nodes was 14. The average postoperative stay was 15 days in laparoscopic group and 23 in the open. Postoperative complications were in 21% and 13% respectively. True invasion (pT4b) according to the morphological study in both groups was 57% and 61%.

Conclusions. Laparoscopic multivisceral resections in patients with locally-advanced colorectal cancer are effective in terms of oncological radicality.