Laparoscopic treatment of patients with colorectal cancer – Technique assessment at an oncological centre
More details
Hide details
Clinic of Oncological Surgery, Holycross Cancer Center, Kielce, Poland
Department of Epidemiology and Cancer Control, Holycross Cancer Center, Kielce, Poland
Faculty of Medical Sciences, University of Economics, Law and Medical Sciences prof. Edward Lipinski, Kielce, Poland
Clinic of Clinical Oncology, Holycross Cancer Center, Kielce, Poland
Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
Corresponding author
Paweł Macek   

Department of Epidemiology and Fighting Cancer, Świętokrzyskie Centrum Onkologii, Kielce, Artwińskiego 3, 25-734, Kielce, Poland
Med Og Nauk Zdr. 2019;25(1):22-26
Introduction and objective:
Colorectal cancer is the third most common cancer in males and the second in females in the Świętokrzyskie region of southeast Poland. In 2015, 354 new colorectal cancer cases in males and 290 in females were reported. Minimally invasive procedures with a modern approach to preoperative care have become a new challenge for the surgeon and a link to robotic surgery. The aim of the study is to analysis surgical complications in the first years from the introduction of laparoscopic procedures for colorectal cancer surgery.

Materials and method:
Laparoscopic colon resection started at the Department of Surgical Oncology of the Świętokrzyskie Cancer Centre in 2011. The method was applied in the treatment of 196 patients mainly with malignant tumour of the colon and the rectum. In 30.6% of patients, open conversion to the procedure was performed. Complications and long-term results were analysed, assessing the operating time, length of hospital stay, local complications as well as early and late mortality.

The duration of laparoscopic procedures was longer compared to the treatment through laparotomy. The median of hospital stay was seven days. The following complications were observed: infection of the surgical wound in 4.1% patients, bleeding or wound dehiscence and hernia anastomosis in 2.4% patients. The conversion was performed in 58 patients, most often because of adhesions (42%) or extensive infiltration of tumour (39%). Early postoperative mortality of up to 30 days after the surgery was observed in 0.5% patient, while within a year after surgery – in 8.2% of patients.

In the course of laparoscopic colon resection, no increase was observed in the number of perioperative complications. A large percentage of conversion demonstrates the need for further training of the operating team.

Juo Y-Y, Hyder O, Haider AH, Camp M, Lidor A, Ahuja N. Is Minimally Invasive Colon Resection Better Than Traditional Approaches? First Comprehensive National Examination With Propensity Score Matching. JAMA Surg. 2014; 149(2): 177. jamasurg.2013.3660.
Cheong C, Kim NK. Minimally Invasive Surgery for Rectal Cancer: Current Status and Future Perspectives. Indian J Surg Oncol. 2017; 8(4): 591–599. doi: 10.1007/s13193-017-0624-7.
Veldkamp R, Kuhry E, Hop WCJ, Jeekel J, Kazemier G, Bonjer HJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005; 6(7): 477–484. doi:10.1016/S1470-2045(08)70310-3.
Giemza A, Smok-Kalwat J, Stępień D, Smorąg L, Macek P, Góźdź S. Nowotwory złośliwe w województwie Świętokrzyskim w 2015 roku. Świętokrzyskie Centrum Onkologii; 2017; //https://www.onkol.kielce. pl/pl/centrum/zaklad-epidemiologii-i-walki-z-rakiem.
Huscher CGS, Bretagnol F, Corcione F. Laparoscopic Colorectal Cancer Resection in High-Volume Surgical Centers: Long-Term Outcomes from the LAPCOLON Group Trial. World J Surg. 2015; 39(8): 2045–2051. doi: 10.1007/s00268-015-3050-4.
van der Pas MH, Haglind E, Cuesta MA, Fürst A, Lacy AM, Hop WC, et al. Laparoscopic versus open surgery for rectal cancer (COLOR II): short-term outcomes of a randomised, phase 3 trial. Lancet Oncol. 2013; 14(3): 210–218.
Benz S, Barlag H, Gerken M, Fürst A, Klinkhammer-Schalke M. Laparoscopic surgery in patients with colon cancer: a population-based analysis. Surg Endosc. 2017; 31(6): 2586–2595. doi:10.1007/s00464- 016-5266-2.
Fagard K, Casaer J, Wolthuis A, Flamaing J, Milisen K, Lobelle JP, et al. Postoperative complications in individuals aged 70 and over undergoing elective surgery for colorectal cancer. Colorectal Dis Off J Assoc Coloproctology G B Irel. 2017; 19(9): O329–O338. https://doi. org/10.1111/codi.13821.
Mamidanna R, Burns EM, Bottle A, Aylin P, Stonell C, Hanna GB, et al. Reduced risk of medical morbidity and mortality in patients selected for laparoscopic colorectal resection in England: a population-based study. Arch Surg Chic Ill 1960. 2012; 147(3): 219–227. archsurg.2011.311.
Cummings LC, Delaney CP, Cooper GS. Laparoscopic versus open colectomy for colon cancer in an older population: a cohort study. World J Surg Oncol. 2012; 10: 31. doi:10.1186/1477-7819-10-31.
Devoto L, Celentano V, Cohen R, Khan J, Chand M. Colorectal cancer surgery in the very elderly patient: a systematic review of laparoscopic versus open colorectal resection. Int J Colorectal Dis. 2017; 32(9): 1237– 1242. doi:10.1007/s00384-017-2848-y.
Parker JM, Feldmann TF, Cologne KG. Advances in Laparoscopic Colorectal Surgery. Surg Clin North Am. 2017; 97(3): 547–560. doi:10.1016/j.suc.2017.01.005.
Gani F, Cerullo M, Zhang X, Canner JK, Conca-Cheng A, Hartzman AE, et al. Effect of surgeon „experience” with laparoscopy on postoperative outcomes after colorectal surgery. Surgery. 2017; 162(4): 880–890. doi:10.1016/j.surg.2017.06.018.
Park IJ, Choi G-S, Lim KH, Kang BM, Jun SH. Multidimensional analysis of the learning curve for laparoscopic resection in rectal cancer. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2009; 13(2): 275–281. doi:10.1007/s00464-014-3569-8.
Meagher AP, Yang S, Li S. Is it right to ignore learning-curve patients? Laparoscopic colorectal trials. ANZ J Surg. 2017; 87(11): 898–902. doi:10.1111/ans.14070.
Gietelink L, Wouters MWJM, Bemelman WA, Dekker JW, Tollenaar RA, Tanis PJ. Reduced 30-Day Mortality After Laparoscopic Colorectal Cancer Surgery: A Population Based Study From the Dutch Surgical Colorectal Audit (DSCA). Ann Surg. 2016; 264(1): 135–140. doi:10.1097/ SLA.0000000000001412.
Journals System - logo
Scroll to top