The Short- and Long-Term Feasibility of Laparoscopic Surgery in Colon Cancer Patients with Bulky Tumors

  • Toshiya NagasakiEmail author
  • Takashi Akiyoshi
  • Yosuke Fukunaga
  • Tetsuro Tominaga
  • Tomohiro Yamaguchi
  • Tsuyoshi Konishi
  • Yoshiya Fujimoto
  • Satoshi Nagayama
  • Masashi Ueno
Original Article



Compared to open surgery for colon cancer, randomized controlled trials have shown that laparoscopic approaches have equivalent short- and long-term outcomes. However, the feasibility of laparoscopy for removal of bulky tumors has not been evaluated. The aim of our study was to determine the short- and long-term feasibility of laparoscopic surgery for bulky (> 8 cm) colon cancer.


A total of 80 patients with bulky tumors (defined as greater than 8 cm in diameter) underwent curative resection from July 2004 to July 2014. Short- and long-term outcomes were compared between patients undergoing laparoscopic (n = 48) and open (n = 32) resection.


Compared to open, the operative time was significantly longer (213 vs. 148 min, p < 0.001), return of bowel function quicker (time to oral intake; 2 vs. 5 days, p < 0.001), and length of stay shorter (10 vs. 13 days, p < 0.001) in the laparoscopic group. Five-year cancer-specific and relapse-free survival was similar with no patients developing local recurrence in either group.


Laparoscopic resection of colon cancers greater than 8 cm in diameter is feasible and oncologically safe with better short-term and equivalent long-term outcomes compared to open surgery.


Laparoscopic surgery Bulky tumor Colon cancer 


Author Contribution

Toshiya Nagasaki mainly designed the study and analyzed the data. All coauthors contributed substantially to the study and fulfilled the requirements for authorship as per the guidelines of the International Committee of Medical Journal Editors. All authors have read and approved the final version of the manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  • Toshiya Nagasaki
    • 1
    Email author
  • Takashi Akiyoshi
    • 1
  • Yosuke Fukunaga
    • 1
  • Tetsuro Tominaga
    • 1
  • Tomohiro Yamaguchi
    • 1
  • Tsuyoshi Konishi
    • 1
  • Yoshiya Fujimoto
    • 1
  • Satoshi Nagayama
    • 1
  • Masashi Ueno
    • 1
  1. 1.Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute HospitalJapanese Foundation for Cancer ResearchTokyoJapan

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