[Open versus laparoscopic resection in non-complicated colon cancer. A systematic review]

The objective of this study was to determine the best surgical option for elective surgery in non-complicated colon cancer by comparing open (OR) and laparoscopic resection (LR).

A systematic review of the literature was performed. Studies of non-complicated colon cancer in adults treated by OS and LS published between 1990 and 2002 were analyzed. The MEDLINE, LILACS and COCHRANE databases were used, employing MeSH terms and free words. Selected studies were analyzed using a specially designed score of methodological quality to examine and compare studies with different types of design. The number of treated patients, 3-year actuarial survival rate, 3-year disease-free survival, recurrence, morbidity, mortality and the methodological quality of primary studies were analyzed. Means, medians, extreme values and weighted means were calculated, and the methodological quality of primary studies was compared using median 95% confidence intervals.

Six hundred eighty related articles were found; of these, 11 were analyzed. Hospital stay was 10.1 days for OR and 6.5 days for LR. Morbidity was 19.5% for OR and 26.9% for LR and mortality was 1.6% and 1.7% respectively. With mean follow-up periods of 58 months for OR and 30 months for LR, actuarial and free-disease survival rates were 74.3% and 75.6% for OR and 87.0% and 89.5% for LR. The median score for methodological quality was 16 for OR and 18.5 for LR.

The early and medium-term results of LR are similar to those observed in OR in patients with non-complicated colon cancer.