F. Konishi et al., LAPAROSCOPIC-ASSISTED COLECTOMY WITH LYMPH-NODE DISSECTION FOR INVASIVE-CARCINOMA OF THE COLON, SURGERY TODAY-THE JAPANESE JOURNAL OF SURGERY, 26(11), 1996, pp. 882-889
The results of performing laparoscopic-assisted colectomy in 20 patien
ts with invasive carcinoma of the colon were analyzed in this study. T
he site of the lesion was the right colon in 5 patients, the transvers
e colon in 1, the left colon in 13, and the rectosigmoid in 1. In 2 pa
tients, the laparoscopic procedure needed to be converted to an open l
aparotomy. Limited lymph node dissection (R1+, R2) was carried out in
10 patients and estensive node dissection (R3) was carried out in 9 pa
tients. The histological depth of invasion in the 18 patients who unde
rwent laparoscopic-assisted colectomy was the submucosa in 9, the musc
ularis propria in 2, and the extramuscular layer in 7. There were 3 pa
tients who developed postoperative complications, 1 of whom underwent
reoperation due to perforation of the colon. The postoperative course
of the patients who underwent laparoscopic surgery was compared with t
hat of a retrospectively selected control group of patients who had un
dergone open laparotomy. The postoperative recovery of the patients wh
o underwent laparoscopic surgery was significantly faster than that of
those who had undergone open laparotomy. Thus, we consider that lapar
oscopic-assisted colectomy with lymph node dissection is technically f
easible provided that patients are properly selected. This procedure m
ay be indicated not only for colonic carcinoma in the early stage, but
also for that with invasion of the muscularis propria or the extramus
cular layer.