LAPAROSCOPIC-ASSISTED COLECTOMY WITH LYMPH-NODE DISSECTION FOR INVASIVE-CARCINOMA OF THE COLON

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.