LAPAROSCOPIC-ASSISTED COLON RESECTION

The popularity and success of laparoscopic biliary tract surgery have persuaded surgeons to explore other applications for rigid endoscopic surgery. From July 1990 to February 1993 a total of 65 patients (mean age 57 years; range 41-82) underwent attempted laparoscopic colon rese ction. Indications for surgical intervention included cancer (39), ade nomatous polyps (14), diverticulosis (10), stricture (1), and foreign- body perforation (1). A laparoscopic-assisted technique whereby the sp ecimen was removed and the anastomosis was completed outside of the ab domen was used in all patients. A dilated umbilical opening was used f or right-sided lesions and a left-lower-quadrant muscle-splitting inci sion for descending and sigmoid colon resections. Two patients require d conversion to open laparotomy. There were no deaths and only four co mplications (pneumonia 1, urinary tract infection 1, prolonged ileus 1 , and subfascial abscess 1). The mean postoperative stay was 4.4 days (range 3-8 days) and the average interval for return to normal activit y was 8 days. Laparoscopic-assisted colon resection appears to be a sa fe and beneficial option for many patients with pathologic disorders o f the large intestine. Future clinical trials are needed to fully dete rmine the appropriateness of this procedure in patients with localized malignancies.