Use of minilaparotomy in the treatment of colonic cancer

The feasibility and safety of a minilaparotomy approach for curative resection of colonic cancer have not been fully elucidated. The purpose of this study was to compare outcomes utilizing this alternative technique with those of conventional laparotomy. Eighty-four patients scheduled to undergo resection for colonic cancer via minilaparotomy between 1997 and 1999 were studied prospectively. The minilaparotomy involved complete resection performed through a skin incision less than 7 cm in length. Sixty-nine patients who underwent a similar resection via a conventional laparotomy between 1994 and 1996 served as the control group. The minilaparotomy approach was successful in 72 of 84 patients. Colectomy type, operating time and histopathological features of tumours were similar between cases and controls, whereas operative blood loss in the control group was significantly greater (P = 0.002). Postoperative times to standing, walking, passage of flatus and urinary catheter removal were significantly shorter in the minilaparotomy group (P = 0.007, P = 0.003, P = 0.03 and P = 0.006 respectively), and analgesic requirements were significantly lower (P = 0.001). At a median follow-up of 24.8 months there have been no tumour recurrences at the minilaparotomy incision sites. A minilaparotomy approach to the curative resection of colonic cancer is an attractive alternative to conventional laparotomy in selected patients.