Laparoscopic multivisceral resection for advanced colorectal cancer: multicenter analysis of short-term and long-term outcomes

Abstract

Abstract Background In response to the rising use of laparoscopic surgery, recent studies have shown that laparoscopic multivisceral resection (MVR) for advanced colorectal cancer is safe, feasible, and provides acceptable oncological outcomes. However, the usefulness of laparoscopic MVR remains controversial. Here, we aimed to compare short-term and long-term outcomes between the laparoscopic and open MVR approaches for patients with advanced colorectal cancer. Methods We retrospectively collected data on 3571 consecutive patients admitted to the Kyushu University National Kyushu Cancer Center for surgical treatment of colorectal cancer between 2004 and 2020. We ultimately analyzed 84 patients who underwent a colectomy with MVR for advanced colorectal cancer. We assessed invasiveness in terms of operating time, blood loss, and complications. Oncological outcomes included 5-year overall survival and recurrence-free survival rates. Results Among the 84 patients analyzed, 29 were treated with a laparoscopic approach, and 55 were treated with an open approach. Compared to the open surgery group, the laparoscopic surgery group had significantly less blood loss (median volume: 167 vs 1058 g, P < 0.005) and shorter hospital stays (15 vs 18 days, P < 0.05). After patients with stage Ⅳ colorectal cancer were excluded from the analysis (laparoscopic surgery group, n = 25; open surgery group, n = 38), the groups showed similar pathologic outcomes and no significant differences in 5-year overall survival (P = 0.87) or recurrence-free survival (P = 0.86). Conclusion A laparoscopic MVR approach for advanced colorectal cancer could be less invasive than an open MVR approach without affecting oncological outcomes in selected patients.