| Theme | What endoscopists should know about laparoscopy-assisted colectomy | |
|---|---|---|
| Title | Long-term outcome of laparoscopic surgery and its perspective | |
| Publish Date | 2002/01 | |
| Author | Hirotoshi Hasegawa | Department of Surgery, Keio University School of Medicine |
| Author | Masahiko Watanabe | 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 for colorectal cancer is still controversial. Over the last 9 years, 417 patients with colorectal cancer underwent laparoscopic surgery in our institution. Of these, 300 patients (72%) had Dukes'A tumours, 54 (13%) Dukes'B, 56 (14%) Dukes'C, and 7 (2%) Dukes'D. Twelve patients had recurrences, including five, in the liver, four, in the local and 3 in the peritoneum. No port site recurrence was observed. The calculated five-year survival rate was 98.7% for Dukes'A, 100.0% for Dukes'B, and 86.0% for Dukes'C. In our randomised controlled trial, comparing short-term outcomes of laparoscopic and open colectomy for advanced colorectal cancer, operative time was longer, blood loss and postoperative analgesic requirements were lower in the laparoscopic group than the open group. Earlier return of bowel motility and shorter hospital stays were observed after laparoscopic surgery. No significant difference was found in serological parameters, except serum C-reactive protein levels, between the two groups. Postoperative complications did not differ between the two groups. It is concluded that laparoscopic surgery for T2 colorectal cancer is feasible with favourable long-and short-term outcomes, however, strict follow-up is necessary for T3 tumours. We also describe the indications for laparoscopic surgery for inflammatory bowel diseases, including Crohn's and ulcertaive colitis. |
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