LAPAROSCOPIC COLORECTAL RESECTION - A MULTICENTER ITALIAN STUDY

Background. The aim of the present study was to evaluate retrospective ly the experience of six surgical units currently performing laparosco pic colorectal surgery. Methods. From November 1991 to January 1994, 2 00 patients (103 male, 97 female; mean age 62.5 years) were candidates for, and received, laparoscopic colorectal resection for benign (54) or malignant (196) lesions. All the units excluded patients with local ly advanced organ tumors and all cases with suspected perforation and ascites. One center submitted to laparoscopic resection only stage I a nd IV adenocarcinoma. All surgeons considered obesity a relative contr aindication. The following data were analyzed: indications, conversion rate to open surgery, operative time, morbidity and mortality, resump tion of gastrointestinal function, number of lymph nodes harvested, ho spital stay. Results. Twenty-one out of 200 patients were converted to open surgery (10.5%); 37 patients had a complete laparoscopic procedu re (17.1%); 137 had an assisted resection (68.5%); and the remaining 5 patients had a facilitated resection. The mean operative time was 208 min (90-480) for assisted resection and 275 min (54-550) for complete laparoscopic resection, The mortality rate was 1.7%; the overall morb idity was 19.6% (major complications 11.2%). All patients quickly beca me ambulatory and showed a prompt resumption of gastrointestinal funct ions, and less postoperative pain if compared with converted cases. Th e average number of lymph nodes was 12.1 (range 1-32). The mean hospit al stay was 8.6 days (range 5-14.5). The mean followup was 16 months ( range 6-24). The recurrence rate 11.7%. Conclusions: Laparoscopy seems to offer the possibility of minimally invasive treatment, but long-te rm follow-up is needed to evaluate the efficacy of laparoscopic surger y in the treatment of colorectal cancer.