Minilaparotomy approach to colon cancer.

Purpose: Many studies have proved the feasibility and safety of a laparoscopic colectomy in comparison to a conventional laparotomy. However, a laparoscopic colectomy requires a minilaparotomy incision to perform the operative procedure. We have introduced a minilaparotomy technique which can perform all the operative procedures through incisions measuring from 3 to 7 cm in length.

Methods: A retrospective comparison of the outcome after a potentially curative resection of colon cancers via minilaparotomy (July 2000 to May 2002) and by conventional laparotomy (May 1997 to June 2000) is reported.

Results: The patient cohort consisted of 27 minilaparotomy cases and 24 conventional laparotomy cases. The patients' characteristics were similar in the two groups. The oncological clearance, in terms of the length of resected specimens, was similar in the two groups, whereas the number of lymph nodes removed was significantly higher in the minilaparotomy group. In addition, the mean operation time, blood loss, length of the laparotomy incision, postoperative time to walking, starting oral intake, and postoperative hospitalization were significantly smaller in the minilaparotomy group.

Conclusion: Our minilaparotomy approach maintained the same curative resection for colon cancers as a conventional laparotomy, but it was less invasive and allowed for an earlier recovery and hospital discharge than conventional laparotomy. The minilaparotomy approach is thus considered to be an attractive alternative to conventional colon surgery.