LAPAROSCOPICALLY ASSISTED BOWEL SURGERY - ANALYSIS OF 114 CASES

In order to help determine the risks and benefits, we retrospectively analyzed the results of our first 114 laparoscopically assisted bowel procedures. Procedures performed consisted of partial colectomy (85), total or subtotal abdominal colectomy (8), total proctocolectomy with J-pouch ileal reservoir(ll), and diverting procedures (10). Forty-nine procedures were for malignancy. The rate of conversion to laparotomy was 13.2%. Oral feedings were resumed in 2.4 days (range 1-5), and bow el function returned in 3.8 days (range 2-8), The average length of st ay was 4.2 days for partial colectomy and 6 days for total, subtotal, and proctocolectomy. The mean return to normal activity for all groups was 16.7 days (10.8 days for partial colectomy), There were no deaths , Major morbidity (6%) consisted of abscess (3), anastomotic leak (2), and hemorrhage (1), Mean operative costs analyzed for the initial 37 patients were higher for laparoscopic colectomies when compared to tra ditional colectomies; however, the mean total hospital costs were less for the laparoscopic procedures. These data suggest that the laparosc opic approach to colorectal resection is an acceptable alternative to laparotomy for a variety of disease processes, allowing patients an ea rly return to normal activity.