LAPAROSCOPIC-ASSISTED COLECTOMY - INITIAL EXPERIENCE

Objective The authors studied the results of laparoscopic colectomies performed by a surgical team on 80 consecutive patients and compared t hese results with standard open colectomies. Methods Eighty consecutiv e laparoscopic-assisted colectomies were performed by Norfolk Surgical Group in a 14-month period and compared to 53 patients who had a conv entional open colectomies, Analysis included indications for surgery, types of procedure, complications, incidence and causes for conversion , length of procedure, duration of postoperative ileus, hospital stay, operating room and total hospital charges, and examination of the pat hologic specimens. Results Many different types of colectomies were pe rformed successfully and safely for a variety of surgical indications. The conversion rate was 22.5%, which decreased to 15% in the second h alf of the series. Complications in patients who underwent laparoscopi c operations were not severe in number or type. The length of the oper ative procedure, operating room charge, and the total hospital charge were greater for patients undergoing laparoscopic-assisted colectomies . Patients who underwent laparoscopic operations had a shorter period of postoperative ileus and less pain, resumed a regular diet sooner, a nd were discharged from the hospital sooner than patients who underwen t open colectomies. There was no significant difference in the patholo gy specimens obtained by laparoscopic-assisted colectomies compared wi th conventional open colectomies for length of specimen, surgical marg ins, and number of lymph nodes retrieved. Conclusions This study indic ated that laparoscopic techniques can be applied safely and effectivel y to a broad range of colonic operations. Laparoscopic-assisted colect omies take longer to perform and are more costly, but are associated w ith less paralytic ileus, less pain, and reduced hospital stay. Laparo scopic colectomies for the treatment oi malignancy are achievable tech nically, but will require careful long-term study.