Laparoscopic surgery minimizes the surgical manipulation of isolated tumor cells leading to decreased metastasis compared to open surgery for colorectal cancer

Sayuri Akiyoshi, Koshi Mimori, Tomoya Sudo, Fumiaki Tanaka, Kohei Shibata, Masaki Mori

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

Purposes: We focused on the possible benefits of laparoscopic surgery to protect against isolated tumor cells (ITC) generated by surgical manipulation in comparison to open surgery. Methods: We performed conventional open surgery and laparoscopic surgery for 25 and 8 cases of colorectal cancer (CRC), respectively. We compared the presence of ITC in the peripheral blood (PB) immediately after surgery via quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) for a representative epithelial marker, carcinoembryonic antigen (CEA). Results: In the 25 patients who underwent open surgery, 8 of the 10 cases with metastasis were positive for ITC in PB, while 13 of the 15 cases without metastasis were negative for ITC. Therefore, we validated that there was a significant clinical usefulness for the detection of ITC in the prediction of metastasis (p=0.0024). We limited our subsequent analysis to the CRC cases with a Dukes stage of B or C to avoid differences due to the background, and we found that the positive ITC rate for metastasis was higher in the 19 patients who underwent open surgery (42.1%) than in the 8 who underwent laparoscopic surgery (37.5%). Conclusions: The short observation period, especially in the laparoscopic surgery group, and the inadequate number of cases limit the ability to draw any definitive conclusions; however, laparoscopic surgery appears to minimize the surgical manipulation, thus leading to reduced ITC from primary CRC compared with open surgery.

Original languageEnglish
Pages (from-to)20-25
Number of pages6
JournalSurgery today
Volume43
Issue number1
DOIs
Publication statusPublished - Jan 2013

All Science Journal Classification (ASJC) codes

  • Surgery

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