EARLY RESULTS OF LAPAROSCOPIC RESECTION OF COLORECTAL-CANCER

OBJECTIVE: to study the immediate and early postoperative results obta ined in patients subjected to laparoscopic resection of colorectal can cer. PATIENTS AND METHOD: a prospective, observational cohort study wa s initiated in January 1993, involving 50 patients subjected to laparo scopic resection for colorectal adenocarcinoma (rectal amputation in 1 0 cases, lower rectal resection in 13, recto-sigmoidectomy in 18, and miscellaneous colectomies in 9 cases). Seventy-percent of the tumors w ere in IUCC stages II and III. Mean follow-up was 21 months. RESULTS: conversion to open surgery was required in 18 cases (36%), Intraoperat ive problems were limited to a single urethral lesion, while postopera tive complications were recorded in 11 patients (22%), and were manage d conservatively: a urinary fistula secondary to the aforementioned ur ethral lesion; subclinical dehiscence of the anastomosis (2 cases); ph lebitis (1 case); infection of the surgical wound (4 cases), and urina ry and pulmonary infection (1 case each). There were no differences be tween converted surgery (i.e. conventional laparotomy) and those opera tions completed endoscopically (with a final assisted or combined mini laparotomy) in terms of the length of the surgical resection piece, th e length of the distal margin of the specimen or the number of lymph n odes. Global hospital stay ranged from 9-12 days, versus 5-7 in the gr oup without complications. Global survival is 78% at 42 months, with a disease-free interval of 53% at this time. CONCLUSIONS: laparoscopic colorectal resection presents an incidence of intra- and postoperative complications characteristic of major surgery, with no differences in surgical specimen size with respect to those operations converted to laparotomy. Global survival is similar to that reported in the literat ure for open surgery.