Trends in Laparoscopic Colorectal Tumor Resections

The number of patients in England that undergo laparoscopic resection of colorectal cancer has increased fifteen-fold in just ten years, according to a new study.

Researchers at the University of Leeds (United Kingdom) collected information on all patients who underwent a major resection for colorectal cancer between 1998 and 2006 from the U.K. National Cancer Data Repository. Analyses were undertaken to determine the frequency of use of laparoscopic surgery across the country as well as patient characteristics that included age, sex, socioeconomic status, tumor stage that could have affected the likelihood of receiving laparoscopic surgery; 30-day operative mortality and duration of hospital stay of patients receiving open and laparoscopic surgery were also compared.

The researchers found that of 160,817 major colorectal cancer resections performed between 1998 and 2006, 3,460 (2.2%) were performed laparoscopically. Over time, there was a significant increase in the number of laparoscopic operations being performed with numbers rising from 98 (0.6%) in 1998 to 1,459 (7.8%) in 2006. Multivariate analysis indicated women were more likely to receive laparoscopic surgery than men, while patients with rectal tumors, advanced Dukes' stages, and comorbidities were less likely to be treated laparoscopically. Patients receiving laparoscopic surgery were also less likely to die within 30 days of the operation, and had shorter hospital stays. The study was presented at the National Cancer Research Institute (NCRI, London, United Kingdom) cancer conference, held during October 2009 in Birmingham (UK).

"Our results are encouraging. Just a decade after the technique was introduced, fifteen times more people with bowel cancer are now benefiting,” said lead author and study presenter Eva Morris, M.D. "It's essential with these new and exciting techniques that surgeons are trained quickly, and our figures show that the national training program for this particular type of surgery has been successful so far. The technique is, however, relatively new so it's important that its outcomes are monitored.”

In August 2006, the U.K. National Institute for Health and Clinical Excellence (NICE; London, UK) issued guidance approving laparoscopic bowel surgery as a possible alternative to traditional open surgery for people with bowel cancer. The U.K. National Health Service (NHS) aims to offer this procedure in all hospitals in the United Kingdom by 2012.

Related Links:
University of Leeds
National Cancer Research Institute
National Institute for Health and Clinical Excellence