Short-term and long-term outcomes of laparoscopic surgery for T4b colon cancer: Comparison with open colectomy

Recent studies have shown that laparoscopic surgery is widely accepted as the optimal procedure for colon cancer resection. However, the safety and feasibility of laparoscopic surgery for T4b colon cancer remain controversial. This study aimed to compare the outcomes of laparoscopic and open surgery for locally advanced colon cancer requiring multivisceral resection. Patients who underwent planned curative resection of T4b colon cancer between 2008 and 2019 were enrolled. We compared short- and long-term outcomes between the two groups. A total of 49 consecutive patients who underwent multivisceral resection for T4b colon cancer were included. Of these, 22 (44.9 %) underwent laparoscopy, while 27 (55.1 %) underwent open surgery. Their clinicopathological characteristics were similar. Compared to open surgery, laparoscopic surgery resulted in significantly less blood loss and a shorter postoperative hospital stay, despite a longer operative time. Although all postoperative complications were more common in the open surgery group (p = 0.043), there was no significant difference between the two groups for major complications (Clavien–Dindo grade ≧3a). The two groups showed similar pathologic factors, and there were no significant differences in disease-free survival (DFS) or overall survival (OS) between them (5-year DFS: 56.4 % vs. 57.0 %, p = 0.907; 5-year OS: 94.4 % vs. 77.5 %, p = 0.224). The most commonly resected adjacent structure was the abdominal wall. Laparoscopic surgery for T4b colon cancer requiring combined resection of other organs achieved acceptable outcomes and is a useful treatment option.