Laparoscopic colorectal resections. Initial experience at the AUB-MC

Laparoscopic colorectal surgery has many advantages to offer. However, it is a complex procedure, and demands advanced technical skills and instrumentation. In addition, its safety when applied to malignant disease is debatable. In this article, we present the early experience and short term results of laparoscopic colorectal resections performed at the American University of Beirut Medical Center.

Between March 1997 and August 1998, 14 patients with various colorectal lesions underwent attempt at laparoscopic colorectal resection, at the American University of Beirut Medical Center. Seven patients were males (50%) and 7 were females (50%); their mean age was 59 yrs (range 40-73 yrs). Ten patients (72%) had malignant disease and 4 patients (28%) had benign disease.

The operation was completed in 13 out of 14 patients (93%). The overall mean operative time was 176 min (range 135-270 min). The operation was taking less time as surgeons gained experience. The average hospital stay was 7.6 days (range 4-11 days). The last four patients, however, stayed less than six days in the hospital. There were no mortalities. There were three complications (21%), two patients had wound infection, and one patient had a prolonged ileus. All were managed conservatively. Ten patients had malignant disease. In these patients, the operative margins were clear of disease. The average number of lymph nodes retrieved was 10.4 (range 3-19). These patients were followed up for an average period of 7.4 months (range 1-16 months). There was one recurrence. There was no port site metastasis in any patient.

Laparoscopic colorectal surgery is feasible and safe. The preliminary results are encouraging. Its application in malignant disease still awaits the results of prospective studies.