COMPLICATIONS OF LAPAROSCOPIC COLORECTAL SURGERY - ANALYSIS AND COMPARISON OF EARLY VS LATTER EXPERIENCE

PURPOSE: The aim of this study was to test if the techniques learned d uring our early learning experience have proved to be effective in red ucing the complications specifically related to the laparoscopic techn ique of colorectal surgery. METHODS: From October 1991 until July 1996 , 195 laparoscopic operations were performed on the colon and the rect um. These data were divided into ''early'' and ''latter'' groups. The conversion reasons and early and late postoperative complications were analyzed and compared. RESULTS: Incidence of conversions required bec ause of iatrogenic injuries showed a decline from 7.3 percent in the e arly group to 1.4 percent in the latter group. Sixty-six postoperative complications were observed in 59 (30.3 percent) patients. Complicati ons specifically related to the technique of laparoscopic surgery occu rred in nine (4.6 percent) patients. These were postoperative bleeding in three patients, port site hernias in five patients, and left urete ric stricture in one patient. Eight (6.5 percent) of these complicatio ns occurred in the early group, whereas one (1.4 percent) occurred in the latter group. Analyzing the conversions caused by intraoperative i atrogenic injuries and the specific postoperative complications togeth er reveals that the incidence of 13.8 percent (17/123) in the early gr oup has been reduced significantly to 2.8 percent (2/72) in the latter group. CONCLUSIONS: On the basis of our experience, we have identifie d techniques, which are discussed in detail, to make laparoscopic colo rectal surgery safe. Strict adherence to these techniques has signific antly reduced the incidence of complications, specifically those relat ed to the laparoscopic technique.