The safety and short-term benefits of keyhole surgery for colon cancer have been debatable. Minimally invasive surgery for cancer reduces surgical trauma but there has been concern that it could lead to tumour recurrence. Despite reduced illness and improved convalescence after keyhole surgery for benign disorders such as gallbladder stones, surgeons have been sceptical about similar advantages of the technique for cancer.
Between 1997 to 2003 Jaap Bonjer (Dalhousie University, Halifax, Canada) and colleagues recruited over 1,200 patients onto the COLOR (COlon cancer Laparoscopic or Open Resection) trial from 29 hospitals in 7 European countries. Half were assigned to keyhole surgery and half to open surgery. The researchers found that the duration of keyhole surgery was longer than that of open surgery. However, patients who underwent keyhole surgery had less blood loss during surgery, earlier recovery of bowel function, needed fewer painkillers, and had a shorter hospital stay when compared with those who underwent open surgery. The investigators also found that mortality and illness did not differ between the two groups.
Professor Bonjer states: "Laparoscopic [keyhole] surgery can be used for safe and radical resection of cancer in the right, left, and sigmoid colon...Further studies of the current surgical approaches for colon cancer are warranted to establish the optimum procedure for the individual patient with colon cancer."
Contact: Professor H.J. Bonjer, QEII Health Sciences Center, Dalhousie University, 1278 Tower Road, Halifax, B3H 2Y9, Canada. T)+1 902 473 8337 Jaap.Bonjer@Dal.Ca
Journal
The Lancet Oncology