| [ Summary ] |
The purpose of this study was to demonstrate our indications and surgical procedures for laparoscopic curative surgery for colorectal cancer and to evaluate its efficacy, compared to endoscopic mucosal resection (EMR) and open surgery. Based on our clinicopathological analysis, we have applied laparoscopic bowel resection, with D0-l lymphadenectomy, to those patients with mucosal cancers, which are difficult to resect endoscopically. We have applied D2 to those with elevated types of submucosal cancer, and D3 to those with depressed types of submucosal cancer, as well as advanced cancer with in the colon or the rectosigmoid. Although EMR appears to be the optimalmodality for laterally spreading tumors, in cases the tumor could not be resected completely, laparoscopic resection might be feasible, not only for its curative result but also for better quality of life. The conventional oncologic principles can be maintained in laparoscopic surgery, using "No touch isolation technique", which could help to prevent port site recurrences. Through April 1999, we did laparoscopic resection on 70 cases (D1:17, D2:29, D3:24). With respect to adequate resection, laparoscopic surgery was comparable with open surgery. In the laparoscopic group, blood loss was less and first flatus was passed earlier. We have experienced no port site recurrence so far. In conclusion, laparoscopic surgery could play a key role in the treatment of colorectal cancer. |