INTESTINE Vol.6 No.1(4-2)

Theme What endoscopists should know about laparoscopy-assisted colectomy
Title Laparoscopic surgery for early colorectal cancer -- indications and surgical procedures
Publish Date 2002/01
Author Jun-ichi Tanaka Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shungo Endo Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Koichi Nagata Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Akiko Umezawa Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Michiaki Iwashita Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Eiji Hidaka Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Hidenobu Ishizaki Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Haruhiro Inoue Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Yoshiro Tamegai Digestive Disease Center, Showa University Northern Yokohama Hospital
Author Shin-ei Kudo Digestive Disease Center, Showa University Northern Yokohama Hospital
[ Summary ] Recent developments in minimal access surgery have altered the surgical approach to colorectal surgery so that the laparoscopic or assisted colorectal resection (LAC) appears to be a very attractive alternative to open surgery. We demonstrated our indications and surgical procedures for laparoscopic surgery for early colorectal cancer, especially in sigmoid colon cancer and rectal cancer. Magnifying colonoscopy and pit pattern diagnosis are proper and feasible in diagnosis of early colorectal cancer and the depth of cancer invasion. Those cases in which the depth of the cancer invasion is limited to the upper third of the submucosal layer can be resected with colonoscopy, however other early colorectal cancer should be treated using LAC procedures including lymphnode dissection. We demonstrated laparoscopic techniques for low anterior resection of the rectum with pelvic truncal autonomic nerve preservation, and also an intracorporeal double stapling technique, using an endoscopic linear stapler and a circular stapler. Those undertaking this type of surgery must have adequate experience in open surgery as well as laparoscopic experience with benign diseases prior to approaching this treatment for carcinoma.
back