Laparoscopic Surgery for Colon Cancer Has Equal Outcomes, Faster Recovery, Than Traditional Surgery
A seven-year international study has shown that less-invasive laparoscopic surgery for colon cancer is just as effective as traditional open surgery when performed by an experienced surgeon – but with faster recovery times and fewer complications. Three University of Miami Sylvester Comprehensive Cancer Center colorectal surgeons were involved in the study, which is published in the May 13 issue of the New England Journal of Medicine.
“Experience clearly counts in laparoscopic surgery,” said Michael D. Hellinger, M.D., F.A.C.S., F.A.S.C.R.S., chief of the Division of Colon and Rectal Surgery at the University of Miami School of Medicine and leader of UM/Sylvester’s colorectal cancer site disease group. Hellinger performed more than 40 cases included in the study, and many more outside of the study. “There is a learning curve with any surgical technique, including laparoscopic procedures.” Two other UM/Sylvester surgeons took part in the study; Laurence R. Sands, M.D., F.A.C.S., F.A.S.C.R.S., and Rene F. Hartmann, M.D., F.A.C.S., F.A.S.C.R.S.
The study compared patient outcomes at both three and five years after surgery and found no significant difference in recovery, relapse, or survival between the two techniques. However, because laparoscopic surgery is performed through a three-inch incision, the risk of infection and the amount of discomfort can be much less than with open surgery. “This study validates what we’ve known for years, which is that laparoscopic surgery can be performed safely,” said Hellinger. Laproscopic patients were able to leave the hospital about a day-and-a-half earlier on average. Complications and re-admissions were the same in the study, but as surgeons become more experienced with laparoscopic procedures, those outcomes also improve.
“When the study began in 1994, none of the surgeons involved had much experience,” noted Hellinger. Laparoscopic surgery was first used to treat colon cancer in 1990. “Our complications rates are clearly less today for laparoscopy, because we don’t see many pneumonias or cardiac complications, which are the most common complications of major surgery,” said Hellinger. “It’s rare for us to see a wound infection in a laparoscopic procedure and the patients are much less uncomfortable.”
This year in the United States about 100,000 people will be diagnosed with colon cancer and more than 90 percent of them will need surgery to remove all or part of the colon or large intestine. The study is the most extensive comparison to date of the two techniques and involved 872 patients and 66 surgeons at 48 medical centers in the United States and Canada. The study began in August, 1994 and closed in August, 2001, although laparoscopic surgery for colon cancer is still readily available as a treatment at UM/Sylvester and many other centers.
The study is available online in the New England Journal of Medicine.
UM/Sylvester was founded in 1992 to provide comprehensive cancer services and today serves as the hub for cancer-related research, diagnosis, and treatment at the University of Miami School of Medicine. UM/Sylvester handles more than 1,100 inpatient admissions annually, performs 2,800 surgical procedures, and treats 2,900 new cancer patients. In 2003, UM/Sylvester administered chemotherapy to more than 9,800 patients and radiation therapy to more than 4,400 patients from throughout the United States and Latin America. All UM/Sylvester physicians are on the faculty of the University of Miami School of Medicine, South Florida’s only academic medical center. In addition, UM/Sylvester physicians and scientists are engaged in more than 150 clinical trials and receive more than $30 million annually in research grants. UM/Sylvester at Deerfield Beach recently opened to better meet the needs of residents of Broward and Palm Beach Counties. This 10,000 square-foot facility at I-95 and S.W. 10th Street offers appointments with physicians from six cancer specialties, complementary therapies from the Courtelis Center, and education and outreach events.