engleski

Safety and advantages of laparoscopic-assisted colectomy.

Aim. Laparoscopic surgery for colorectal cancer, especially laparoscopic rectal surgery, has been introduced recently. Laparoscopic colectomy has developed rather slowly because of the relatively complicated anatomy and demanding surgical techniques. This study was designed to report our early experience with laparoscopic-assisted colorectal procedures done at this Department, and presents important lessons we have learned therefrom. Materials and Methods. The first laparoscopic colon resection was performed at this Department on 16 January 1996. Clinical and operation records of 38 operations for benign and malignant diseases done by 2005 were reviewed. The data retrieved included patient demographics, selected intraoperative parameters, and postoperative outcomes. Similar data were collected for 1, 207 casematched open surgical procedures performed during the same period. All data were entered into a database and analysed using a statistical software package. Results. The diagnoses included: cancer (92.1% vs. 95%), polyps (5.3% vs. 3.1%) and rectovaginal fistula (2.6% vs. 1.9%). In four (10.5%) cases, laparoscopy was converted to open surgery because of bleeding and locally advanced disease. The laparoscopic- assisted procedures performed included: six right hemicolectomies, nine left hemicolectomies, seven anterior resections and 16 abdominoperineal resections. The mean operative time was longer for laparoscopic-assisted colectomy than for open surgery (208 minutes vs.150 minutes, P<0.05), but the mean duration of analgesic requirements (2.5 days vs. 4.5 days, P=0.008), mean time to resumption of oral diet (2.42 days vs. 3.95 days, P=0.005) and mean length of hospital stay (7 days vs. 11 days, P=0.007) were shorter, and the morbiddity rates (13.1% vs. 40.1%, P<0.05) were lower. No respiratory and local wound complications were found in our laparoscopic- assisted group. Conclusions. Laparoscopic-assisted colorectal surgery has proved a safe and effective treatment modality with statistically significant clinical benefits for strictly selected patients

Laparoscopy ; colorectal cancer ; operative time ; morbidity ; hospital stay.

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