Uptake of Laparoscopic Colorectal Cancer Surgery at Regional Cancer Centre, South India

Sandeep Nayak P; Chunduri Srinivas; Jaiprakash Gurawalia; Vishnu Kurpad; Shiva Kumar

Volume : VI, Issue : IV, April - 2017

Uptake of Laparoscopic Colorectal Cancer Surgery at Regional Cancer Centre, South India

Sandeep Nayak P, Chunduri Srinivas, Jaiprakash Gurawalia, Vishnu Kurpad, Shiva Kumar

Abstract :

Introduction

The uptake of laparoscopy in colorectal cancer (CRC) surgery has been gradual and incomplete. Over the last 10 years, the use of laparoscopic approach has been encouraged over open colorectal surgery by the results of various randomized trials which demonstrated equivalent outcomes in terms of disease free survival and overall survival. However, in spite of evidence favouring laparoscopic resection for colonic surgery the uptake of the approach has been slow.

Material and methods

This is a single institution based retrospective analysis of treatment records of patients registered at our institute between January 2004 and December 2013. There were 2357 patients of CRC registered at our institute in this period. Out of these 1116 patients underwent definite surgery. We compared the surgical details and pathology records of patient undergoing definitive surgery, and compared the outcomes of open and laparoscopic approaches.

Results

Elective surgery was performed for 1116 cases of CRC, 712 (64%) rectal cases and 404(36%) colon cancer cases. Mean age of male and female patients were 50.3 years (� 14.61) and 49.4 years (�13.76) respectively. Out of 712 rectal cases, 70 (10%) were treated laparoscopically while 642 underwent open surgery. The laparoscopic rectal cancer surgery rose from 3.6% in 2005 to 26.6% in 2013. The conversion rates declined from 57.1% in 2009 to 11.8% in 2013. Out of 404 patients of colonic cancer, 8 (1.98%) patients underwent laparoscopic surgery over these years. The performance of laparoscopic colon cancer surgery saw a rise from 2.17% in 2010 to 14.3% in 2013.

Conclusion: Lapaproscopic surgery is being gradually taken–up as an approach for CRC in the regional cancer centre. The reason for gradual increase could be due to predominance of rectal cancer over colonic cancers in India. The evidence in support of laparoscopic surgery for rectal cancer from recent randomised trials may boost the uptake of laparoscopy.