CONTROLLED TRIAL OF LAPAROSCOPIC-ASSISTED VS OPEN COLON RESECTION IN A PORCINE MODEL

Background: Several series of laparoscopic colon resection have been r eported in the Literature with varied results; however, no controlled series of laparoscopic vs open colon resection has been reported. The purpose of this study was to determine the relative safety and adequac y of laparoscopic colon resection in a controlled trial using a porcin e model. Methods: Domestic pigs (n = 23) were randomly divided into tw o groups. Animals underwent either an open or laparoscopic-assisted se gmental resection of the sigmoid colon. The open resections were perfo rmed through a 20-cm midline incision and the laparoscopic technique u tilized five 12-mm ports. Laparoscopic resection took twice as long to complete as open resection (P < 0.001), Return of gastric function wa s significantly faster in the laparoscopic group than in the open grou p (P < 0.032). Results: No significant differences were found in total length of resection, proximal or distal margins, number of lymph node s recovered, length of mesenteric vessel resected, or time to return o f bowel function, At vivisection, more adhesions to the abdominal wall were noted in the open group (P < 0.002). One death occurred in the l aparoscopic group 2 h postoperatively (8.3% mortality) while all open group pigs survived, However, there was no statistically significant d ifference in mortality rates by chi-square analysis (P > 0.5). Conclus ions: Despite longer operative time, laparoscopic intervention is tech nically feasible, safe, and may offer significant postoperative benefi ts due to fewer abdominal adhesions.