PROSPECTIVE EVALUATION OF LAPAROSCOPIC-ASSISTED LARGE-BOWEL EXCISION FOR CANCER

Objective The authors described their experience with laparoscopic-ass isted colorectal resection for colorectal carcinoma, both curative and palliative, with emphasis on patient selection. The techniques of the operations were described. Summary Background Data Laparoscopic color ectal procedures for treatment of benign lesions have been shown to be less painful and to enhance early postoperative recovery. However, us e of laparoscopic procedures for treatment of colorectal cancer are co ntroversial. The authors have used laparoscopic techniques for curativ e and palliative resections of colorectal carcinoma with satisfactory early results. Methods One hundred patients with colorectal carcinoma were selected over a 30-month period for laparoscopic-assisted colon a nd rectal resection. For 17 patients, laparoscopy revealed bulky tumor or locally advanced disease, and open surgery was performed, For 83 p atients, laparoscopic-assisted colorectal resections were attempted. P rocedural data and postoperative results were entered prospectively. T he median follow-up period was 15.2 months (range, 2.5-32.7 months). R esults Fourteen of 83 patients eventually required conversion to open surgery. The median operative time was 180 minutes. The patients could return to a normal diet in a median of 4 days. The median number of d oses of analgesics required was two, and the median hospital stay was 6 days. The morbidity rate was 12%, and there was no deaths attributab le to the procedure. There were four distant recurrences and one pelvi c recurrence. Conclusions Laparoscopic-assisted colorectal resection f or selected patients is feasible, and early postoperative results are encouraging. This procedure does not appear to be associated with an e xcessive recurrence rate, and long-term follow-up is necessary for lat e survival figures.