Open Versus Laparoscopic Oncological Resections for Colon Cancer: An Experience at an Average-Volume Center

Cureus. 2024 Sep 30;16(9):e70535. doi: 10.7759/cureus.70535. eCollection 2024 Sep.

Abstract

Although laparoscopy has some limitations related to tumor size or location along the colon, it has been demonstrated that the oncological results are just as good as for open surgery. One can also add to the benefits faster recovery and start of chemotherapy, with lower rates of complications. Our study aimed to compare open surgery to laparoscopy for non-complicated colon tumors operated in an average case-load center and appreciate its feasibility with regards to the T stage, lymph node yield and conversions. The study is retrospective and expanded over four years (January 2020-January 2024). One hundred sixty-two patients were included in the study. We observed that female patients were frequently operated through laparoscopy (p=0.003). T1 and T2 tumors represented the majority of the tumors in the laparoscopy group (p=0.004). No statistical difference existed in terms of lymph node yield. Laparoscopy was avoided for tumors of the splenic angle (p=0.006). Concluding our results, minimally invasive surgery for non-complicated colon cancer is non-inferior to open surgery. Considerable expertise is required to take on more complex cases such as difficult-to-access tumors or large, invasive cancers. It can and should be offered to patients as an alternative to open surgery.

Keywords: colon cancer; d2 lymphadenectomy; laparoscopy; oncology; open surgery vs laparoscopy.