Surgery For Transverse Colon Cancer Research Articles

Comparison of pathologies in patients operated for transverse colon tumor with embryogenic and anatomical insights

Aim: Transverse colon cancers account for only about 10% of all colon cancers. It is generally known that proximal and distal colon tumours have different genetic and biological features. he transverse colon serves as the division point between proximal and distal regions. In this study, transverse colon cancer was classified both embryologically and anatomically, and a comparative analysis was conducted based on pathological results. Method: A retrospective study was conducted on patients who underwent surgery for transverse colon cancer at Ankara Bilkent City Hospital between 2019 and 2023. Patients were classified embryologically as proximal and distal, and anatomically as hepatic angle, middle, and splenic angle, and pathological results were compared among these groups. Results: For embryogenic classification in terms of the final pathological staging, Group A had 1 (1.47%) in Stage 1, 32 (47.05%) in Stage 2, 26 (38.23%) in Stage 3, and 9 (13.23%) in Stage 4. Group B had 2 (2.54%) in Stage 1, 29 (50%) in Stage 2, 20 (34.48%) in Stage 3, and 7 (12.06%) in Stage 4. There was no significant difference between the groups. For anatomical classification , the number of patients in Stages 1, 2, 3, and 4 for Groups 1, 2, and 3 were as follows: Stage 1: 2 (3.5%), 1 (3.57%), 0 (0%); Stage 2: 29 (50.87%), 17 (60.81%), 15 (37.5%); Stage 3: 20 (35.7%), 7 (25%), 19 (47.5%); Stage 4: 7 (12.28%), 3 (10.71%), 6(15%).There was no statistically significant difference between the groups (p > 0.05). Conclusion: The pathological results and stages of transverse colon cancers classified embryologically and anatomically showed no significant differences among the groups.

Cadaveric and CT angiography study of vessels around the transverse colon mesentery

BackgroundLaparoscopic and robotic surgery for transverse colon cancer are difficult due to complex fusion of the foregut and midgut and variation of the vessels of the transverse colon. Although the vessels of the right colon have been investigated, middle colic artery (MCA) variation and the relationship with vessels around the transvers colon are unknown. We investigated variation of the MCA using computed tomography angiography (CTA) and cadaver specimen and the relationship between the superior mesenteric vein (SMV) and MCA using CTA. The classification of vessels around the transverse colon may lead to safer and reliable surgery.MethodsThis study included 505 consecutive patients who underwent CTA in our institution from 2014 to 2020 and 44 cadaver specimens. Vascular anatomical classifications and relationships were analyzed using CT images.ResultsThe MCA was defined as the arteries arising from the superior mesenteric artery (SMA) that flowed into the transverse colon at the distal ends. The classifications were as follows: type I, branching right and left from common trunk; type II, the right and left branches bifurcated separately from the SMA; and type III, the MCA branched from a vessel other than the SMA. Type II was subclassified into two subtypes, type IIa with one left branch and type IIb with two or more left branches from SMA. In the CTA and cadaver studies, respectively, the classifications were as follows: type I, n = 290 and n = 31; type IIa, n = 211 and n = 13; type IIb, n = 3 and n = 0; and type III, n = 1 and n = 0. We classified the relationship between the MCA and left side of the SMV into three types: type A, a common trunk runs along the left edge of the SMV (n = 173; 59.7%); type B, a right branch of the MCA runs along the left edge of the SMV (n = 116; 40.0%); and type C, the MCA runs dorsal of the SMV (n = 1; 0.3%).ConclusionsThis study revealed that The MCA branching classifications and relationship between the SMV and MCA. Preoperative CT angiography may be able to reliably identify vessel variation, which may be useful in clinical practice.

Oncological outcomes of open, laparoscopic and robotic colectomy in patients with transverse colon cancer.

Literature concerning surgical management of transverse colon cancer is scarce, since many key trials excluded transverse colon cancer. The aim of this study was to evaluate clinical and oncological outcomes comparing open, laparoscopic and robotic transverse colon cancer resection. Consecutivepatients who underwent elective surgery for transverse colon cancer between December 2005 and July 2021 were included. Data were kept in a prospective database approved by the institutional ethics committee. Primary outcome was overall and disease-free survival. Secondary outcomes included complications, operative time, length of stay and lymph node harvest. Statistical analysis was corrected for age and tumour localisation. Two hundred and forty-six (38 robotic, 71 open and 137 laparoscopic resections) were recruited in this study. There were five conversions during laparoscopic procedures. Operative time was significantly shorter in robotic vs laparoscopic procedures (195 vs 238min, p = 0.005) and length of stay was shorter in robotic vs laparoscopic and open group (7 vs 9 vs 15days, p < 0.001). There was no difference in overall complications. R0 resections were similar. Lymph node harvest was highest in the robotic group vs. laparoscopic or open (32 vs. 29 vs. 21, p < 0.001). Overall survival was 97%, 85% and 60% (p < 0.001) and disease-free survival was 91%, 78% and 56% (p < 0.001) for the robotic, laparoscopic and open groups, respectively. Minimally invasive surgery for transverse colon cancer is safe and offers good clinical and oncological outcomes. Robotic resection is associated with significantly shorter operating times, higher lymph node harvest, lower conversion rate and does not increase morbidity. Differences in disease-free and overall survival should be further explored in randomised controlled trials.

Delayed gastric emptying after surgery for transverse colon cancer: diagnosis, management and prevention

Delayed gastric emptying is a syndrome of gastric motility disorder with slow gastric emptying as the main sign, provided that mechanical factors such as intestinal obstruction and anastomotic stricture are excluded. The incidence of delayed gastric emptying after colon cancer surgery is 1.4%, mainly after transverse colon cancer surgery. Most of the studies on delayed gastric emptying are case reports, lacking systematic studies. The diagnoses and treatments can be draw on the experience of delayed gastric emptying after pancreatic surgery. Our retrospective study indicated that the incidence of delayed gastric emptying after surgery for transverse colon cancer was 4.0%, higher than that for other colon cancer. Patients who underwent gastrocolic ligament lymph node dissection were at higher risk than those who did not (3.6% vs. 0.8%). Gastrocolic ligament lymph node dissection and stress are causative factors for delayed gastric emptying after surgery for transverse colon cancer. We add the gastrografin test upon the diagnostic criteria of the International Study Group for Pancreatic Surgery, which is simple and practical. Nasogastric tube decompression, enteral nutrition combined with parenteral nutrition, glucocorticoids, and prokinetic agents can cure most patients with postoperative delayed gastric emptying. All the patients with postoperative delayed gastric emptying were cured in our studies. Strict indications for gastrocolic ligament lymph node dissection (patients with cT3-4 and cN+) may decrease the occurrence of delayed gastric emptying after surgery for transverse colon cancer.

Vascular variations encountered during laparoscopic surgery for transverse colon, splenic flexure, and descending colon cancer: a retrospective cohort study

BackgroundLaparoscopic surgery for cancer located in the transverse colon or splenic flexure is difficult because of vascular variability in this region and adjacent vital organs such as the pancreas, spleen, and duodenum.MethodsThis retrospective cohort study involved 51 patients who underwent laparoscopic surgery for colon cancer at Tokushima University Hospital from July 2015 to December 2020. Variations of the middle colic artery (MCA), left colic artery (LCA), middle colic vein (MCV), and first jejunal vein (FJV) and short-term outcomes of laparoscopic surgery in patients with each vascular variation were evaluated.ResultsVariations of the MCA, LCA, MCV, and FJV were classified into four, three, five, and three patterns, respectively. The short-term outcomes of laparoscopic surgery for transverse colon cancer in patients with MCA variations and those with FJV variations were evaluated, and no significant difference was found in the operation time, blood loss, postoperative complication rate, time from surgery to start of dietary intake, or time from surgery to discharge among the different variations. Additionally, no significant differences were found in the short-term outcomes of laparoscopic surgery for descending colon cancer in patients with LCA variations.ConclusionPreoperative assessment of vascular variations may contribute to the stability of short-term outcomes of laparoscopic surgery for transverse colon, splenic flexure, and descending colon cancer.

Laparoscopic-assisted surgery versus open surgery for transverse colon cancer: A multicenter retrospective study.

Previous randomized controlled trials demonstrated similar oncological outcomes between laparoscopic-assisted (LA) and open (OP) colectomy; however, patients with transverse colon cancer were not analyzed. The aim of this study was to confirm the oncological safety and the advantages of the short- and long-term results of LA surgery for transverse colon cancer in comparison to OP surgery. The study data were retrospectively collected from the databases of four hospitals. Patients with transverse colon cancer who underwent LA or OP R0 or R1 resection were registered. Among the 204 patients, 149 underwent OP colectomy and 55 underwent LA colectomy. The median follow-up period was 43 months. The rate of conversion to OP resection was 7.3%. The 5-year overall survival rate of the LA group was higher than that of the OP surgery group for all-stage patients (97.5% vs. 91.1%, P = 0.108), and it was similar in Stage II and Stage III patients (94.1% vs. 94.2%, P = 0.510). The LA group had significantly lower blood loss and a significantly longer operative time in comparison to the OP surgery group. Furthermore, the postoperative hospital stay was significantly shorter (9 vs. 13 days, P = 0.001) and the incidence of Grade ≥III complications was lower in the LA group (3.7% vs. 14.8%, P = 0.031). We concluded that LA surgery for transverse colon cancer is oncologically safe and yields better short-term results in comparison to OP surgery.

Virtual laparoscopic imaging for performing central vascular ligation through laparoscopic surgery for transverse colon cancer.

Virtual laparoscopic imaging for performing central vascular ligation through laparoscopic surgery for transverse colon cancer.

Long-Term Outcomes of Radical Surgery for Transverse Colon Cancer Staged from I to IIIC.

BackgroundNo study has reported the risk factors associated with the prognosis of patients with transverse colon cancer. Therefore, we aimed to demonstrate the long-term outcomes of transverse colon cancer patients undergoing radical surgery and explore the prognostic factors.Materials and MethodsThe clinical data of a total of 366 patients with transverse colon cancer staged from I to IIIC undergoing radical surgery from February 1992 to May 2017 were retrospectively analyzed. Clinicopathological features were recorded, and univariate and multivariate analyses were conducted to evaluate the association between the factors and overall survival (OS) as well as disease-free survival (DFS). Kaplan–Meier curves were generated to assess the association between TNM stage and OS and DFS, respectively.ResultsThe median follow-up time was 62 months, and the 5-year OS and DFS rates were 87.5% and 86.5%, respectively. In addition, a significant difference was also found in the OS and DFS curves according to TNM stage. The N classification, vascular invasion, differentiation, preoperative CA199, preoperative CA125 and preoperative AFP were significantly associated with OS according to univariate analysis, while N classification and differentiation were independent prognostic factors for OS according to multivariate analysis (both P < 0.05). Similarly, N classification, vascular invasion, differentiation, preoperative CA199, preoperative CA125, and preoperative AFP were statistically correlated with DFS according to univariate analysis, while N classification and preoperative CA199 were independent prognostic factors for DFS according to multivariate analysis (both P < 0.05).ConclusionN classification was an independent factor for both OS and DFS, while differentiation and CA199 were independent prognostic factors only for OS and DFS, respectively.

P3-064 - A case of duodenum dissemination after surgery for colon cancer which immunotherapy was significantly effective

The patient was a 73 year old woman who received surgery for transverse colon cancer in December 2014. Histopathologic examination findings were tub2, pT4b, pN1, sH0, sM0, ly2, v0, Stage IIIa. After XELOX theraphy two courses were performed, FOLFIRI plus Pmab theraphy twelve courses were performed. Stenosis due to duodenum dissemination was observed in December 2015, and a laparoscopic gastrojejunostomy was performed. Later, the tumor marker value of the patient significantly increased, and enlargement of duodenum dissemination was observed by abdominal CT. From April 2016, treatment was switched to mFOLFOX6 plus Pmab theraphy and five courses were subsequently performed. Still, metastasis to the abdominal wall was observed. According to results of the microsatellite instability test of MSI-H, the patient was registered into a clinical trial for Pembrolizumab, which is anti-PD-1, and administration began from June. The tumor marker value significantly decreased, and a reduction in the size of the duodenum dissemination over time could also be observed by abdominal CT. Significant tumor reduction was observed, indicating that immune therapy may be significantly effective in some cases.

Analysis of the Vascular Interrelationships Among the First Jejunal Vein, the Superior Mesenteric Artery, and the Middle Colic Artery.

The technical difficulty of laparoscopic surgery for transverse colon cancer is partly due to the vascular variability around the middle colic vessels. Although individual variations in the arteries or veins in this area were previously investigated, the vascular interrelationships between these vessels remain unknown. This study was designed to investigate the vascular interrelationships between the arteries and veins around the middle colic vessels and to provide practically useful classifications. This study included 105 consecutive patients who underwent colorectal surgery for colorectal tumors in our institution in 2016. Patients with a history of colectomy were excluded. Vascular anatomical classifications were analyzed by evaluating thin-slice images of preoperative contrast-enhanced computed tomography. Vascular anatomical patterns were classified according to whether the first jejunal vein ran behind (type A) or in front (type B) of the superior mesenteric artery. Type B was subclassified into two subtypes, depending on whether the middle colic artery originated cephalad (type B1) or caudad (type B2) to the first jejunal vein. We identified 83 (79.0%) cases of type A, 11 (10.5%) of type B1, and 11 (10.5%) of type B2. In 17 cases, the middle colic vein drained into the inferior mesenteric vein, and all of these were type A (P = 0.0202). Furthermore, in eight cases, the middle colic vein drained into the first jejunal vein, and all of these were type B (P < 0.0001). This study elucidated the vascular interrelationships around the middle colic vessels. Our findings provided important knowledge for laparoscopic surgery in treating transverse colon cancer.

Splenic Infarction after Surgery for Transverse Colon Cancer that was Treated Successfully by Conservative Therapy

Splenic Infarction after Surgery for Transverse Colon Cancer that was Treated Successfully by Conservative Therapy

Clinical and oncological outcomes of single-incision laparoscopic surgery for transverse colon cancer

Single institutional consecutive experiences with single-incision laparoscopic surgery (SILS) for transverse colon cancer are reviewed, and the resulting clinical and oncological outcomes are evaluated. In all, 59 patients (29 women) with a median age of 71.0 years were treated with SILS for clinically diagnosed colon cancer. A tumor located at the hepatic flexure or within about 10 cm distal to the hepatic flexure was treated by right hemicolectomy. Extended right hemicolectomy was performed in cancer which required the ligation of the root of the mid-colic artery. A tumor at the splenic flexure was treated by left hemicolectomy, and transverse colectomy was performed for other transverse colon tumors. In 54 patients treated with SILS, the mean skin incision length was 2.67 cm: 26 right hemi-colectomies, 19 transverse colectomies, 4 extended right hemi-colectomies and 2 left hemi-colectomies were performed in this series. The mean operative time and blood loss were 181.9 min and 44.9 mL, respectively. The mean number of harvested lymph nodes was 29.0. Early post-operative complications were occurred in 2 patients (3.7%). The patients were discharged after a mean period of 13.0 postoperative days. Five (11.1%) tumor recurrences or metastases occurred in 45 patients with Stage I to Stage III disease with the median follow-up of 30 months. Our initial experiences showed that SILS can be used to treat transverse colon cancer with good clinical and mid-term oncological outcomes.

Preoperative Evaluation of Blood Vessel Anatomy Using 3-Dimensional Computed Tomography for Laparoscopic Surgery of Transverse Colon Cancer

This study describes the efficacy of the evaluation of blood vessel anatomy by 3-dimensional computed tomography (3D-CT) for laparoscopic surgery for transverse colon cancer (TCC). A total of 102 patients with TCC were examined by preoperative 3D-CT to clarify their blood vessel anatomy at Tokyo Medical University Hospital between January 2010 and December 2015, before undergoing laparoscopic surgery using the obtained 3D-CT data. Regarding blood vessel variation, the middle colic artery (MCA) was present in all patients (100%). The common duct type was observed in 89 patients (87.3%), and a type of branch separate from the superior mesenteric artery was observed in 13 patients (12.7%). The accessory MCA was present in 25 patients (24.5%). The middle colic vein was present in all patients (100%), and it drained into the following vessels: the superior mesenteric vein, gastrocolic trunk, first jejunal vein, and inferior mesenteric vein [67 (65.8%), 25 (24.5%) 8 (7.8%), and 2 (1.9%) patients, respectively]. Regarding the surgical outcome, the bleeding volume was 43 g, the operative time was 218 minutes, the number of harvested lymph nodes was 21, the proximal resection margin was 164 mm, the distal resection margin was 105 mm, and the length of postoperative hospital stay was 10 days. Although complicated variations and anomalies in the MCA and the contiguous veins were observed, preoperative 3D-CT will be useful for surgeons performing laparoscopic surgery on patients with TCC.

Perioperative and short-term oncological outcomes of single-port surgery for transverse colon cancer.

To compare the perioperative and short-term oncological outcomes of patients who underwent single-port surgery (SPS) with those of patients who underwent multi-port surgery (MPS) for transverse colon cancer. The records of consecutive patients who underwent SPS (n=75) or MPS (n=41) for transverse colon cancer in our department between January, 2008 and December, 2015 were analyzed retrospectively. Operative times were significantly shorter in the SPS group than in the MPS group (185 vs. 195min, respectively; P=0.043). There were no significant differences in operative procedures, blood loss, or extent of lymph node dissection. The rate of postoperative complications was similar in both groups, but the length of hospital stay was significantly shorter in the single-port group than in the multi-port group (8 vs. 11days, respectively; P<0.001). Oncological outcomes were similar in both groups. The disease-free survival rate at 2years did not differ significantly between the groups (91.1 vs. 94.9%, respectively; P=0.414). Our experience demonstrates that SPS is safe and can provide oncological outcomes equal to those of MPS for transverse colon cancer.

Short- and long-term outcomes of laparoscopic surgery vs open surgery for transverse colon cancer: a retrospective multicenter study.

PurposeThe purpose of the present study was to compare the perioperative and oncologic outcomes between laparoscopic surgery and open surgery for transverse colon cancer.Patients and methodsWe conducted a retrospective review of patients who underwent surgery for transverse colon cancer at six Hallym University-affiliated hospitals between January 2005 and June 2015. The perioperative outcomes and oncologic outcomes were compared between laparoscopic and open surgery.ResultsOf 226 patients with transverse colon cancer, 103 underwent laparoscopic surgery and 123 underwent open surgery. There were no differences in the patient characteristics between the two groups. Regarding perioperative outcomes, the operation time was significantly longer in the laparoscopic group than in the open group (267.3 vs 172.7 minutes, P<0.001), but the time to soft food intake (6.0 vs 6.6 days, P=0.036) and the postoperative hospital stay (13.7 vs 15.7 days, P=0.018) were shorter in the laparoscopic group. The number of harvested lymph nodes was lower in the laparoscopic group than in the open group (20.3 vs 24.3, P<0.001). The 5-year overall survival (90.8% vs 88.6%, P=0.540) and disease-free survival (86.1% vs 78.9%, P=0.201) rates were similar in both groups.ConclusionThe present study showed that laparoscopic surgery is associated with several perioperative benefits and similar oncologic outcomes to open surgery for the resection of transverse colon cancer. Therefore, laparoscopic surgery offers a safe alternative to open surgery in patients with transverse colon cancer.

Initial experience of robotic versus laparoscopic colectomy for transverse colon cancer: a matched case-control study.

BackgroundRobotic surgery for transverse colon cancer has rarely been described. This study reports our initial experience in robotic resection for transverse colon cancer, by comparing robotic transverse colectomy (RC) to laparoscopic transverse colectomy (LC) in terms of safety, feasibility, short-term outcomes, and the surgeon’s psychological stress and physical pain.MethodsThe study population included the first 22 consecutive patients who underwent RC between March 2013 and December 2014 for histologically confirmed transverse colon adenocarcinoma. These patients were compared with 22 matched patients undergoing LC between December 2010 and February 2013. Patients were matched based on age, gender, body mass index (BMI), American Society of Anesthesiology (ASA) score, American Joint Committee on Cancer (AJCC) tumor stage, and tumor location (ratio 1:1). Mortality, morbidity, operative, and short-term oncologic outcomes were compared between groups. The operating surgeon’s stress and pain were assessed before and after surgery on a 0–100-mm visual analog scale.ResultsThe demographic and preoperative characteristics were comparable between RC and LC patients. No group difference was observed for intraoperative complications, blood loss, postoperative pain, time to flatus, time to regular diet, and hospital stay. RC was associated with longer operative time than LC (260 min vs. 225 min; p = 0.014), but the overall operative and robotic time in the RC group decreased over time reflecting the increasing experience in performing this procedure. No conversion to laparotomy was observed in the RC group, while two LC patients were converted due to uncontrolled bleeding and technically difficult middle colic pedicle dissection. Postoperative complications (Dindo-Clavien grade I or II) occurred in 11.3 % of patients with no group difference. Mortality was nil. All resections were R0, with >12 lymph nodes harvested in 90.9 % of RC and 95.5 % of LC patients. The surgeon’s stress was not different between RC and LC, whereas the surgeon’s hand and neck/shoulder pain were significantly lower after RC.ConclusionsRC for transverse colon cancer appears to be safe and feasible with short-term outcomes comparable to LC.

Outcome of Laparoscopic Versus Open Resection for Transverse Colon Cancer

BackgroundLaparoscopic resection for transverse colon cancer remains controversial. The aim of this study is to investigate the short- and long-term outcomes of laparoscopic surgery for transverse colon cancer. MethodsA total of 278 patients with transverse colon cancer from a single institution were included. All patients underwent curative surgery, 156 patients underwent laparoscopic resection (LR), and 122 patients underwent open resection (OR). The short- and long-term results were compared between two groups. ResultsBaseline demographic and clinical characteristics were comparable between two groups. Conversions were required in eight (5.1 %) patients. LR group was associated with significantly longer median operating time (180 vs. 140 min; P < 0.001). Median estimated blood loss was significantly less in LR group (90 vs. 100 ml; P = 0.001). Time to first flatus and oral intake was significantly earlier in LR group. Perioperative mortality and morbidity rate were not significantly different between two groups. Tumor size, number of lymph nodes harvested, length of proximal, and distal resection margin were comparable between two groups. Postoperative hospital stay was significantly shorter in LR group (9 vs. 10d; P < 0.001). Five-year disease-free survival and overall survival rate were similar between two groups. ConclusionsLaparoscopic resection for transverse colon cancer is associated with better short-term outcomes and equivalent long-term oncologic outcomes.

Cranially approached radical lymph node dissection around the middle colic vessels in laparoscopic colon cancer surgery.

Laparoscopic lymph node (LN) dissection around the middle colic vessels is technically demanding, thus raising controversy regarding the role of laparoscopic surgery for transverse colon cancer. We herein describe a cranial approach method to perform radical LN dissection around the middle colic vessels. The key characteristic of this approach is early division of middle colic vessels prior to mobilization of the colon. From April 2010 to September 2013, 27 patients with colon cancer received laparoscopic LN dissection around the middle colic vessels using this cranial approach. Their surgical and short-term outcomes were reviewed. The mean number of harvested LNs was 29 (range, 6-50). The mean operative time and intraoperative blood loss were 274 min (range, 160-362 min) and 42 mL (range, 3-247 mL), respectively. There were no serious intraoperative complications or conversions to open surgery. There were two patients with stage 0, 7 with stage I, 12 with stage II, and 6 with stage III. No recurrent case was observed with a median follow-up period of 30 months (range, 9-48 months). We consider this approach feasible and useful for radical LN dissection around the middle colic vessels during laparoscopic colon cancer surgery.

Unique acidophilic inclusions in the submucosal layer of colon – a case report

We report a case of colon cancer which revealed unique acidophilic inclusions in the submucosal layer of colon broadly. The patient was a 70-year-old male. He underwent surgery for transverse colon cancer. The cancer invaded the subserosal layer. There was a large number of acidophilic inclusions in the submucosal layer of the colon broadly. The inclusions were found around the cancer and were invaded by the cancer. The inclusions had clear borders and included fat cells, vessels, nerve plexus, collagen fibers, and elastic fibers. They were periodic acid-Schiff stain negative and did not show positivity for amyloid in the direct fast scarlet stain. In ultrastructual study, the inclusions revealed homogenous dense material accompanied by collagen fibers and elastic fibers. We cannot find any literature about the unique inclusions, and conclude they are unknown material deposits in the colonic wall.

Short- and long-term results of laparoscopic surgery for transverse colon cancer

We investigated the feasibility of laparoscopic surgery for transverse colon cancer (TCC) by examining the results of this procedure, and comparing the short- and long-term outcomes with those for right-sided and sigmoid colon cancer (OSCC). The subjects consisted of 117 patients with TCC. Their complications, forms of recurrence and disease-free and 5-year survival rates were compared to those of 564 patients with OSCC. There were no significant between-group differences in the patient background. The average length of the operation in the TCC group was 215 min and that in the OSCC group was 184 min (p < 0.05). There were also no significant between-group differences in the average blood loss, which was 83.9 and 70.5 g, respectively. No significant difference was observed between groups by stage in terms of the disease-free survival rates, which were 94.4 and 79.1 % for stage II and III in the TCC group, and 92.4 and 78.8 % for stage II and III in the OSCC group. The incidence of intraoperative and postoperative complications was low, and the five-year survival rate was favorable. As favorable results of laparoscopic colectomy (LAC) for TCC were also obtained at other sites in a multicenter randomized controlled trial, LAC is expected to become a standard therapy for TCC.