Laparoscopic colorectal surgery – experiences of 100 cases

• Published in: Zeitschrift für Gastroenterologie
• Main Authors: Papp, A, Morvay, K, Weltner, J, Fülöp, C, Kupcsulik, P
• Format: Conference Proceeding
• Language: English
• Published: 31.05.2007
• DOI: 10.1055/s-2007-982706
• ISSN: 0044-2771

At the 1st Dept. of Surgery, Semmelweis University we have been routinely performing laparoscopic colorectal procedures (LCR) since 2004. We analyze 100 cases which were operated in our department between January 2005 and February 2007. The main criterion of patient-selection was as follows: not suitable for laparoscopic surgery if the tumor is in stage T4, on the other hand, there was no exclusion based on age (22–85yrs). Also, malignant and benign pathologies were operated. The average age was 62 years; the ratio of women/men was 1:1.1. In 72 cases (72%), surgery for malignant disease was performed. In this group, the tumor was located in the rectum in 30 (42%), in the sigmoid colon in 22 (31%), in the descending colon in 3 (4%), in the transverse colon in 5 (7%), and in the right-sided colon in 12 cases (17%). The indication was based on benign disease in 28 cases (28%). The anastomosis was performed extracorporally in 42%, intracorporally in 36% and in any other way or no anastomosis was performed in 22% of the cases. Conversion was needed in 16 cases (16%), in 5 cases (5%) because of intraoperative injury. The average operation time was 3 hours and 58 minutes. Blood transfusion was necessary in 17% of the cases. For 80 patients (80%), there were no complications of any kind. Anastomotic leakage was observed in 4 patients (4%). Wound complication rate was as high as 9%. First postoperative stool happened on the third day on average. Average length of postoperative stay was 6.3 days for the complication-free group. It is clear from our preliminary results that laparoscopic colorectal surgery can be performed with results similar to open surgery. Selection of the patients is useful. Large tumorsize makes the technique complicated, infiltration of the surrounding tissues is a contraindication of laparoscopic approach, but malignant disease is not, and oncological radicality of LCR is more precise than the open method. Long surgery time could be significantly reduced with practise.