Biomedical Research

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Clinical comparison of hand-assisted laparoscopic surgery and traditional laparotomy in radical resection of colorectal cancer

Background: Colorectal cancer is a common malignant tumor of the digestive system. Minimally invasive surgeries, with Hand-Assisted Laparoscopic Surgery (HALS) as a representative technology, have challenged Traditional Laparotomy (TL). Some studies indicated that HALS has an apparent advantage in terms of intestinal function recovery, complications, and other parameters.

Objective: In this study, we aimed to compare the clinical effects of HALS and TL in radical resection of colorectal cancer, in order to investigate the feasibility of HALS in colorectal cancer resection.

Methods: We retrospectively analysed the clinical data on HALS and TL at our hospital from 2009 to 2011 (28 rectal carcinoma patients underwent laparoscopic surgery and 32 rectal cancer patients underwent traditional open surgery), and compared the differences in operative time, blood loss, number of dissected mesenteric lymph nodes, intestinal function recovery time, postoperative hospital stay, and postoperative complication incidence.

Results: The HALS group exhibited less blood loss, shorter intestinal function recovery time, and shorter postoperative hospital stay than the TL group (intraoperative blood loss: 80.5 ± 13.3 ml vs. 170.5 ± 35.5 ml, t=12.650, p-value<0.05; intestinal function recovery time: 45.4 ± 15.8 h vs. 89.5 ± 13.3 h, t=11.750, p-value<0.05; postoperative hospitalization stay: 8.2 ± 2.0 days vs. 11.6 ± 2.0 days, t=6.518, pvalue< 0.05). However, the difference in operative time, number of intraoperative lymph nodes dissected, and postoperative complication incidence between the two groups was not significant (p-value>0.05).

Conclusions: HALS showed the advantages of less bleeding, quicker recovery, and minimal invasiveness over TL. Moreover, it did not increase the operative time or postoperative complications. HALS could achieve the same results as those obtained with TL in radical resection.

Author(s): Jingquan Guo, Jingfeng Chen, Xiyuan Zhu