LAPAROSCOPIC-ASSISTED COLORECTAL SURGERY - LESSONS LEARNED FROM 240 CONSECUTIVE PATIENTS

PURPOSE: To audit the development and outcomes of laparoscopic colorec tal surgery at the Royal Brisbane Hospital. METHODS: Since July 1991, laparoscopic-assisted colectomy for benign and malignant colorectal di sease has been performed on more than 300 patients at the Royal Brisba ne Hospital. This paper summarizes the outcome for the first 240 patie nts who underwent a laparoscopic colorectal procedure. All laparoscopi c data were collected prospectively, and for selected studies, data we re compared with open surgical controls. RESULTS: Nineteen patients re quired open conversion (7.9 percent). There was a significant decrease in wound infection rates in patients having a laparoscopic-assisted c olectomy (3.6 percent) compared with historical controls (7.9 percent) (P < 0.05; chi-squared). There were five anastomotic leaks, five lapa rotomies for postoperative adhesive obstruction, and four perioperativ e deaths. A total of 103 patients had a procedure for colorectal cance r. Of the 79 potentially curative procedures, there have been 5 (6.3 p ercent) recurrences to date. CONCLUSION: The overall morbidity and mor tality in this series seem to be acceptable compared with that of open procedures.