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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
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[Minimally invasive surgery for colorectal cancer was introduced in a safe and well controlled manner]

Erik Agger1, Marit Tiefenthal2, Charlotta Larsson3

  • 1med dr, överläkare, kolorektal-sektionen, Skånes uni-versitetssjukhus; medicinska fakulteten, Lunds universitet.

Lakartidningen
|June 10, 2026
PubMed

Insights

Minimally invasive surgery (MIS) is not inferior to open surgery (OPEN) for colorectal cancer, showing better short-term outcomes and improved long-term survival. MIS offers advantages like reduced mortality and shorter hospital stays.

Area of Science:

  • Oncology
  • Surgical Oncology
  • Public Health

Background:

  • Minimally invasive surgery (MIS) adoption for colorectal cancer varies.
  • Assessing the safety and efficacy of MIS compared to open surgery (OPEN) is crucial during its introduction.

Purpose of the Study:

  • To compare short-term and long-term outcomes of MIS versus OPEN for colorectal cancer in Sweden.
  • To evaluate the safety and effectiveness of MIS during its nationwide introduction.

Main Methods:

  • Nationwide population-based study in Sweden.
  • Comparison of patients undergoing MIS and OPEN for colorectal cancer (surgery 2010-2018).
  • Cox regression models used for secondary analyses of short-term and long-term outcomes.

Main Results:

  • MIS was not inferior to OPEN for short-term outcomes (2012-2018) and long-term overall survival (2010-2016).
  • MIS demonstrated advantages: lower early mortality, shorter hospital stay, and decreased reoperation rates.
  • MIS was associated with better overall survival, reducing 5-year mortality risk by 13% for colon and 12% for rectal cancer.

Conclusions:

  • MIS was introduced safely and in a controlled manner for colorectal cancer in Sweden.
  • MIS offers significant short-term and long-term benefits compared to OPEN.
  • MIS should be equally accessible to all suitable colorectal cancer patients across Sweden.

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