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Laparoscopic surgery for treatment of colon cancer

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SBU Assessment

Presents a comprehensive, systematic assessment of available scientific evidence for effects on health, social welfare or disability. Full assessments include economic, social and ethical impact analyses. Assessment teams include professional practitioners and academics. Before publication the report is reviewed by external experts, and scientific conclusions approved by the SBU Board of Directors.

Findings by SBU Alert

This is a translation of version 1, published on September 25, 1998. The latest version of this report is not available in English.

Laparoscopic surgery has been tested as an alternative to traditional open surgery in patients with colon cancer. Moderate* scientific knowledge concerning the short-term medical effects suggests that more rapid mobilization after surgery is possible, thereby shortening the duration of medical care. Poor* knowledge is available concerning the long-term medical effects. Some of the case descriptions suggest a suspected increased risk for relapse of cancer in the abdominal wall. Based on the material available, definite conclusions cannot be drawn concerning the risk for relapse. The effects on costs and the quality of life have not been evaluated. The assessment by SBU Alert suggests that this method should be used only within the scope of randomized controlled studies until further evidence becomes available.

*This assessment by SBU Alert uses a 4-point scale to grade the quality and evidence of the scientific documentation. The grades indicate: (1) good, (2) moderate, (3) poor, or (4) no scientific evidence on the subject.

This summary is based on a report prepared at SBU in collaboration with Assoc Prof Bo Anderberg, MD PhD, Huddinge University Hospital, and Martin Janson, M.D, Huddinge University Hospital. It has been reviewed by Assoc Prof Eva Haglind, MD PhD, Sahlgrenska University Hospital.

Alert is a joint effort by the Swedish Council on Technology Assessment in Health Care (SBU), the Medical Products Agency, the National Board of Health and Welfare, and the Federation of Swedish County Councils.

References

  1. Lacy AM, Garcia-Valdecasas JC, et al. Short term outcome analysis of a randomized study comparing laparoscopic vs open colectomy for colon cancer. Surg Endosc 1995; 9:1101-1105.
  2. Stage JG, Schulze S, et al. Prospective randomized study of laparoscopic vs open colonic resection for adenocarcinoma. Br J Surg 1997; 84: 391-396.
  3. Franklin ME, Rosenthal D, et al. Prospective compairson of open vs. laparoscopic colon surgery for carcinoma. Dis Colon Rectum 1996; 39: 35-46.
  4. Fleshman JW, Nelson H, et al. Early results of laparoscopic surgery for colorectal cancer. Dis Colon Rectum 1996; 9:53-58.
  5. Wexner SD, Cohen SM. Port site metastases after laparoscopic colorectal surgery for cure of malignancy. Br J Surg 1995; 82:295-298.
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Published: Revised: 10/15/2003
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