PROSPECTIVE COMPARISON OF LAPAROSCOPIC AND CONVENTIONAL ANTERIOR RESECTION

A prospective comparison of laparoscopically assisted (n = 11) and con ventional (n = 14) anterior resection in patients with sigmoid colon o r upper rectal cancer was carried out. Patients were not randomized: a ge and the presence of metastases determined the type of surgery. Lapa roscopic assistance was used to mobilize the tumour and minimize the a bdominal incision. This was achieved in all patients and six of the 11 required only a muscle-splitting incision. The mean(s.d.) operating t ime was longer for laparoscopic than conventional surgery (205(31) ver sus 123(26) min, P = 0.01). The mean(s.d.) time to reintroduction of n ormal diet (2.5(0.2) versus 3.6(0.3) days, P = 0.01), postoperative an algesia requirement (2.6(0.4) versus 7.4(2.1) doses of pethidine, P = 0.01) and length of hospital stay (12.3(3) versus 14.3(6) days, P = 0. 08) were less in the laparoscopic group. Histopathological examination of the resection specimens showed similar results for the two procedu res. Major complications were few and occurred in a similar proportion of patients treated laparoscopically or conventionally. Laparoscopica lly assisted anterior resection is technically feasible, adequate tumo ur excision can be achieved and recovery after operation is enhanced.