engleski

Laparoscopic surgery for colorectal cancer

Introduction: Surgical resection is the primary treatment for colon cancer. The introduction and acceptance of laparoscopic colectomy for cancer has been gradual for a number of reasons including the fact that it is technically challenging, has less than dramatic patient benefits, and perhaps most significantly it could theoretically represent a compromise as an oncologic procedure. Evidence suggests that laparoscopic colectomy for colon cancer is safe, feasible, and an oncologic adequate resection can be performed with acceptable operative times and conversion rates. Recently published results from the largest and first prospective randomized trial with sufficient statistical power have shown that laparoscopic colectomy is as effective as open colectomy in preventing recurrence and death from colon cancer. In experienced hands, laparoscopic colectomy for the cure of colorectal cancer appears to be equivalent to open surgery and may become standard in selected patients. Methods and results: The first laparoscopic colon resection was performed at our Department on July 2nd 2003. Until September 31st 2006 we performed 14 operations. The patients were 10 males and 4 females with a mean age 67 (43-75) ; ASA grades I-III. According to the Dukes classification there was one patient operated in Dukes A, 8 patients in Dukes B and 3 patients in Dukes C. Different procedures, like sigmoidectomy, right and left hemicolectomy, anterior resections of rectum and abdominoperineal resections were performed. The mean operative time was 215 minutes. During the same period we have one conversion because of left urether lesion. The overall perioperative mortality rate was nil. There were no postoperative complications and reoperations. In all specimens, negative margin were revealed histopathologically. The average number of lymph nodes retrieved was 15. Mean postoperative hospital stay was 10.3 days. Conclusion: Laparoscopic colorectal surgery represents a safe and feasible method with more convenient postoperative course for the patients, satisfactory oncological outcomes and promising long-term effects.

colorectal cancer; laparoscopic surgery

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