Laparoscopic and open approaches to colon resection have equivalent long-ter
m outco
mes and oncologic integrity for the treat
ment of colon cancer. Differences in short-ter
m outco
mes should therefore help to guide surgeons in their choice of operation. We hypothesized that
mini
mally invasive colecto
my is associated with superior short-ter
m outco
mes co
mpared to traditional open colecto
my in the setting of colon cancer.
Materials and methods
Patients undergoing nonemergent colectomy for colon cancer in 2012 and 2013 were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) targeted colectomy participant use file. Patients were divided into two cohorts based on operative approach—open m>versusm> minimally invasive surgery (MIS). Univariate, multivariate, and propensity-adjusted multivariate analyses were performed to compare postoperative outcomes between the two groups.
Results
A total of 11,031 patients were identified for inclusion in the study, with an overall MIS rate of 65.3% (m>nm> = 7200). On both univariate and multivariate analysis, MIS approach was associated with fewer postoperative complications and lower mortality. In the risk-adjusted multivariate analysis, MIS approach was associated with an odds ratio of 0.598 for any postoperative morbidity compared to open (m>Pm> < 0.001).
Conclusions
This retrospective study of patients undergoing colectomy for colon cancer demonstrates significantly improved outcomes associated with a MIS approach, even when controlling for baseline differences in illness severity. When feasible, minimally invasive colectomy should be considered gold standard for the surgical treatment of colon cancer.