| Theme |
What endoscopists should know about laparoscopy-assisted colectomy |
| Title |
Laparoscopic colectomy; a less invasive and safer operation for colorectal cancer? |
| Author |
Masazumi Okajima |
Department of Surgery II, Hiroshima University, Faculty of Medicine |
| Author |
Yasutomo Ojima |
Department of Surgery II, Hiroshima University, Faculty of Medicine |
| Author |
Takeshi Kurihara |
Department of Surgery II, Hiroshima University, Faculty of Medicine |
| Author |
Yoshio Miura |
Department of Surgery II, Hiroshima University, Faculty of Medicine |
| Author |
Toshimasa Asahara |
Department of Surgery II, Hiroshima University, Faculty of Medicine |
| [ Summary ] |
The safety and less invasiveness of laparoscopic colectomy for malignancies was evaluated in terms of recurrence, perioperative complications, and clinical parameters, in 109 cases treated with laparoscopic procedures and 153 cases of open surgery. There was no recurrence in either group during the two-year follow-up period. There were two cases with complications specific to laparoscopic procedures, one was a port site hernias, resulting in ileus and the other, bleeding from a splenic tear, both requiring laparotomy. These complications occurred at the beginning of our experience and did not take place after improvements in the procedure. Ileus occurred more frequently in open procedures (9 cases vs 2 cases). Two cases in the open group required relaparotomy. Despite requiring longer operating times, laparoscopic operations resulted in less bleeding, less pain, earlier removal of urethral tubes, shorter bed rest periods, shorter postoperative hospital stays, and earlier recovery from fever. Although white blood cell count, and CPK, CRP levels were not different in these groups, interleukin-6 was lower in the laparoscopic group. Short-term results from our experience, indicated that with certain levels, of technical skill and care, laparoscopic colectomy for malignancy is a less invasive and equally safe procedure as compared to open surgery. |