Comparison of laparoscopic complete mesocolic excision and traditional radical operation for colon cancer in the treatment of stage III colon cancer.

PURPOSE

To compare the clinical efficacy and safety between laparoscopic complete mesocolic excision (CME) and traditional radical operation for colon cancer in the treatment of stage III colon cancer.

METHODS

A total of 196 patients with stage III colon cancer treated in out hospital from January 2014 to February 2016 were selected and divided into two groups using a random number table. One group (CME group, n=98) received laparoscopic CME, while another group (Traditional group, n=98) underwent traditional radical operation for colon cancer. The surgery-related indexes and perioperative complications were compared between the two groups, the pathological diagnosis of the patient's surgical specimens was recorded, and the survival of all patients was followed up.

RESULTS

The general clinical characteristics of the patients were comparable between the two groups, and no perioperative death occurred. The operation time had no statistically significant difference between the two groups (p=0.190). There was overtly less intraoperative blood loss and shorter postoperative hospital stay in the CME group than those in the Traditional group (129.35±34.54 mL vs. 162.43±38.16 mL, p<0.001, 13.8±3.1 days vs. 15.2±3.4 days, p=0.003). There were no statistically significant differences in the indwelling time of drainage tube after operation, the time of liquid diet after operation and the recovery time of normal diet after operation between the two groups (p>0.05). The time for passage of flatus after operation was significantly shorter in the CME group than that in the Traditional group (p=0.016). The incidence rate of postoperative complications was lower in the CME group (12.2%) than that in the Traditional group (17.3%), but the difference was not statistically significant (p=0.421). The comparisons of surgical specimens revealed that there were no statistically significant differences in tumor size, stage, histopathological classification and differentiation grade between the two groups (p>0.05). The number of lymph nodes dissected and the number of positive lymph nodes detected were clearly greater in the CME group than in the Traditional group (p<0.001). At the end of the follow-up, the overall survival rate and tumor-free survival rate were notably higher in the CME group than in the Traditional group (p=0.046, p=0.038).

CONCLUSION

In comparison with traditional radical operation for colon cancer, laparoscopic CME has higher yield of lymph nodes dissected, smaller intraoperative blood loss, no increase in perioperative complications, and higher overall survival and tumor-free survival of patients, demonstrating it as safe and applicable in the treatment of stage III colon cancer.