LAPAROSCOPICALLY ASSISTED COLORECTAL SURG ERY - RESULTS IN BENIGN ANDMALIGNANT DISEASE - A PROSPECTIVE TRIAL IN 120 PATIENTS

We present our results with laparoscopic-assisted colorectal surgery i n 120 patients during the time from January 1993 to September 1996. Th e types of procedures cover almost the whole spectrum of colorectal su rgery. They included hemicolectomies, sigmoid resections, low anterior resections, Hartmann closures, proctocolectomies and rectopexies. 127 patients were subjected to laparoscopic operation, 7 needed conversio n to open surgery (7% conversion rate). Average operation time was 145 +/-58 min, length of postoperative stay 12+/-4 days. Oral food intake was started at the second day postoperatively without major problems. We observed perioperative complications in 21 cases (17%). There were 5 anastomotic leaks, 4 wound infections, 1 pneumothorax and 2 postoper ative bleedings. 4 patients had clinical signs of prolonged bowel para lysis. 2 patients died as a consequence of anastomotic leaks, 2 of oth er reasons. In the postoperative period we saw a marked faster recover y and a lower complication rate compared to our conventionally operate d patients and postoperative pain was less. In cases of malignant dise ase no rise in rate of recurrence was observed during follow-up (avera ge 18 months) compared to open surgery. Until the results of long-term studies are published laparoscopic procedures should still be restric ted to early tumor stages and palliative procedures.