Laparoscopic colectomy has been increasingly reported as an option for
the treatment of colonic pathology. However, there is very little inf
ormation regarding perioperative morbidity and the cost effectiveness
of this technique. The purpose of this study is to review our first ye
ar of experience with laparoscopic colon resection. Data collected inc
ludes: age, technique (open laparotomy, laparoscopic, laparoscopic/con
verted open), Karnofsky score, complications, specimen size/nodes, OR
time, hospital stay, and cost. This is a consecutive series of 140 ele
ctive colonic resections including 102 open laparotomies (0) and 38 la
paroscopic (L) cases. The indications for surgery have included adenoc
arcinoma col/rect (O = 59, L = 9), diverticular disease (O = 10, L = 1
0), adenomatous polyp (O = 3, L = 7), IBD (Crohn's, CUC) (O = 15, L =
4), rectal prolapse (O = 3, L = 4), and other (O = 12, L = 4). There w
ere no significant differences with respect to age (O = 60.7 +/- 1.5;
L = 54.8 +/- 3.8; C = 66.1 +/- 3.1), perioperative morbidity (O = 11%;
L = 15%; C = 17%). The laparoscopic and laparoscopic converted cases
required significantly more time compared to the open laparotomy group
(O = 2.1 +/- 0.2 hours; L = 2.9 +/-0.2; C = 3.4 +/- 0.2). There were
significantly less intraoperative blood loss associated with laparosco
pic procedures compared with either open or converted groups of patien
ts (O = 687 +/- 54 cc; L = 157 +/- 19; C = 491 +/- 50). Bowel function
returned more quickly in the laparoscopic group compared with the oth
er groups (O = 4.9 +/- 0.2 days; L = 3.0 +/- 0.3; C = 4.3 +/- 0.6). In
addition, the hospital stay was significantly shorter in the laparosc
opic group compared with either of the other two groups (O = 9.9 +/- 0
.4 days; L = 6.0 +/- 0.5; C = 9.3 +/- 0.8). Finally, there was signifi
cantly lower cost associated with the successfully completed laparosco
pic colectomy group (O = 14449 +/- 696; L = 12131 +/- 612; C = 17583 1
731).