LAPAROSCOPIC COLORECTAL SURGERY - ANALYSIS OF 113 CASES

Background/Aims: The aim of the study is to relate our five years expe rience with laparoscopic colorectal surgery. Materials and Methods: On e hundred-thirteen procedures were performed between October 1990 and February 1996, 7% of which were performed as emergencies. Elective ind ications (93%) included 45 cancers, 31 cases of diverticulosis, 18 cas es of benign tumor, and 11 other reasons. Procedures performed were si gmoidectomy (61 cases), rectal resection (12 cases), segmental colecto my (15 cases), right hemicolectomy (14 cases) and restoration of conti nuity following a Hartmann's procedure (5 cases) and miscellaneous (6 cases). Results: Operative complications occurred in 14% of the cases. The conversion rate to laparotomy was 6%. Post operative complication s occurred in 14% of the patients. Reoperation was performed in 7% of the cases and overall mortality was 1.7%. Mean length of hospital stay was 9.6 days. Long-term oncology results demonstrated no recurrence f or DUKES stage A disease followed-up from 5 to 65 months, and 2 recurr ence on 11 DUKES B or C. All DUKES D patients died in an average of 17 months. No abdominal wall metastases were seen during the follow-up p eriod in 45 patients with cancer who were treated. Conclusions: Laparo scopic colo-rectal surgery is technically feasible and has an acceptab le complication rate. The best indications are treatment of benign dis orders, principally excision of polyps and treatment of uncomplicated diverticulosis. This is also a good approach to treat degenerated poly ps (DUKES A). The procedure should be assessed in curative excision of DUKES B or C disease.