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Laparoscopic versus open colectomy for locally advanced T4 colon cancer: a meta-analysis of clinical and oncological outcomes.

Authors: Mauro Podda MD FACS, Adolfo Pisanu MD PhD, Alessia Morello MD, Edoardo Segalini MD, Kumar Jayant MD PhD FACS, Gaetano Gallo MD, Massimo Sartelli MD, Federico Coccolini MD, Fausto Catena MD PhD FRCS, and Salomone Di Saverio MD FACS FRCS.
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Colon cancer accounts for 9.4% and 10.6% of all tumours in the female and male populations, respectively [Sung H 2020]. Approximately 10-20% of patients diagnosed with colon cancer present with locally advanced tumours penetrating the surface of the peritoneum or directly invading other organs [Brenner H 2014].

This meta-analysis aimed to review the currently available evidence on laparoscopic colon cancer resection, evaluate short postoperative and long-term oncological outcomes after laparoscopic colectomy, and compare the above with conventional open surgery.

We searched medical databases for publications of comparative studies, including randomised controlled trials, prospective cohort studies, and retrospective cohort studies comparing laparoscopic and open surgery as a treatment for T4 locally advanced tumours colon cancers. The searches are up-to-date to April 2021.

Twenty-four comparative, non-randomised studies were included, analyzing a total of 18434 patients: 9024 who received laparoscopic colon resection and 9099 underwent open surgery.

Laparoscopic resection was associated with lower rates of postoperative mortality and complications compared to open.


No significant difference in the radicality of the surgical operation (R0) and cancer recurrence rate was found.

RO Resection


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