Camera-guided surgery through small incisions works better than conventional surgery for colon cancer and related diseases, at least in the short term recovery, a new review of previous studies confirms. In the long term, researchers found no difference between the two.
Researchers at Charité - Universitatsmedizin Berlin analyzed 25 randomized controlled trials in which the laparoscopic method - or "keyhole" surgery - was compared with the conventional method, in which a large vertical incision is made in the abdomen and the surgeon directly handles the organs. The studies compared outcomes up to three months following surgery.
In these trials, patients underwent colon resections, in which the diseased portion of the colon was excised, much like cutting a section out of a rubber hose, and the two disease-free ends stapled together. The trials included 3,526 patients, most of whom had colon cancer. Laparoscopy can also be used for diverticulitis, Crohn's disease and ulcerative colitis.
The study appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that produces systematic reviews of healthcare interventions, based on the content and quality of existing clinical trials on the topic.
"We found that the laparoscopic approach has advantages, at least in the short-term," says Dr. Wolfgang Schwenk, who led the review. "It causes less pain, pulmonary function is improved, and gastrointestinal function returns to normal sooner. Also, patients can be discharged from the hospital earlier, and overall, they just feel better."
The only disadvantage of the laparoscopic approach is that it takes an average of 42 minutes longer. "The laparoscopic approach is technically more demanding," says Schwenk. "It's more difficult to work with the indirect view than it is to touch the organs and handle them with your hands."
Most, but not all, colorectal cancers are suitable for the new technique, says the review, which appears to confirm other recent individual studies showing positive results for laparoscopy for colon cancer.