| Theme |
Expansion of Indications for Endoscopic Mucosal Resection of Early Gastrointinal Cancer |
| Title |
Laparoscopic Colectomy for Colorectal Carcinoma |
| Author |
Seiichiro Yamamoto |
Department of Surgery, Keio University School of Medicine / Department of Surgery, National Cancer Center |
| Author |
Masahiko Watanabe |
Department of Surgery, Keio University School of Medicine |
| Author |
Hirotoshi Hasegawa |
Department of Surgery, Keio University School of Medicine |
| Author |
Hideo Baba |
Department of Surgery, Keio University School of Medicine |
| Author |
Kentaro Yamamoto |
Department of Surgery, Keio University School of Medicine |
| Author |
Masaki Kitajima |
Department of Surgery, Keio University School of Medicine |
| [ Summary ] |
The role of laparoscopic surgery in the treatment of colorectal carcinoma is controversial. Between June, 1992, and December, 2000, 372 patients with colorectal cancer underwent laparoscopic surgery in our institute. The 5-year survival rate, using the Kaplan-Meier method, was 98.5% for Dukes' A, 100% for Dukes' B, and 84.9% for Dukes' C. 11 patients developed recurrent cancers. The results of laparoscopic surgery in patients with early colorectal cancer were favorable. For advanced colorectal carcinoma, the oncologic outcome appears not to be compromised by the laparoscopic approach, at least in the short term. However, we are still awaiting the long term results of many randomized, controlled trials, currently being perfor med in various countries.
On the other hand, the indications for surgical resection with lymph node dissection, after endoscopic resection for colorectal carcinoma has invaded the submucosal layer, is still controversial. In addition, it is not easy to endoscopically resect superficial tumors when the size exceeds 40mm, or the lesions fail to lift after submucosal injection (lifting-sign negative tumor). Laparoscopic resection is an adequate surgical procedure for patients with those lesions. |