Related Experiment Video
Updated: Mar 22, 2026
Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Selection for laparoscopic resection confers a survival benefit in colorectal cancer surgery in England
Alan Askari1, Subramanian Nachiappan2, Andrew Currie2
1Surgical Epidemiology, Trials and Outcome Centre (SETOC), St Mark's Hospital, Imperial College London, Harrow, Middlesex, HA1 3UJ, UK. alan.askari@nhs.net.
Introduction:
Laparoscopic surgery is being increasingly used in colorectal cancer resections. The aim of this national study was to determine whether laparoscopy confers a long-term survival advantage in colorectal cancer.
Methods:
A national administrative data set (Hospital Episode Statistics-HES) encompassing all elective hospital admissions in England between 2001 and 2011 was analysed. All patients that had a colorectal cancer resection (open or laparoscopic) were identified. Cox hazard regression was used to determine differences in overall survival (10 year) between the open and laparoscopy groups.
Results:
A total of 141,682 patients underwent elective surgery for colorectal cancer, of which 20.9 % (n = 29,550) had a laparoscopic procedure. The median 5-year survival in the open group was 36.1 months compared with 46.1 months in the laparoscopic group (p = <0.001). Survival analysis demonstrated laparoscopy to be an independent predictor of survival. Patients who underwent laparoscopic resection were 18 % less likely to die than patients who had an open CRC resection (HR 0.82, CI 0.79-0.83, p < 0.001). This survival benefit persisted even when initial post-operative mortality (90 day) was excluded (HR 0.87, CI 0.85-0.90, p < 0.001). Subgroup analysis, exploring the effect of CRC laparoscopic surgery on survival in the elderly (>79 years old), demonstrated similar survival benefit amongst patients treated using laparoscopy (HR 0.90, CI 0.86-0.94, p < 0.001). Patients not undergoing adjuvant chemotherapy were more likely to survive if they underwent laparoscopic resection (HR 0.81, CI 0.78-0.83, p < 0.001). Similarly, patients undergoing adjuvant chemotherapy demonstrated a survival benefit if a minimal access surgical approach was utilised (HR 0.86, CI 0.81-0.91, p < 0.001).
Conclusion:
Laparoscopy confers a survival benefit, irrespective of age and administration of adjuvant chemotherapy, beyond the initial post-operative period in patients selected for elective colorectal cancer resection.
