[Laparoscopic versus conventional surgery in the treatment of colorectal diseases]

The aim of the study was to compare the results obtained with laparoscopic (LPS) and laparotomic (LPT) colorectal resection after our initial experience with the laparoscopic technique. Fifty-six patients were submitted to colorectal resection, 26 with the LPS and 30 with the LPT technique. Eighteen patients out of 26 in the LPS group and 22/30 in the LPT group had malignancies. All resections were performed with a curative intent. The mean operating time was 220 min in the LPS group and 208 min in the LPT group. Mean blood loss was 287 ml and 312 ml, respectively (blood transfusions were needed in 1/26 and in 7/30 patients). The rates of major complications were 9.5% and 5.7%, respectively. There was no mortality. The conversion rate for the LPS group was 19.2%. In the cancer patients, no significant difference was observed between the two groups as regards postoperative staging. The mean length of specimens and the mean distance of the tumours from the resection margins were adequate. The mean number of lymph nodes harvested was 11.8 in the LPS group as against 18.5 in the LPT group. No early recurrences were observed. Resumption of gastrointestinal function was faster in the LPS patients who underwent the surgical procedure under general anaesthesia associated with epidural anaesthesia/postoperative analgesia. In conclusion, these preliminary results indicate that laparoscopic colorectal surgery is feasible and that the resections in cancer patients appear to be oncologically adequate. Long-term follow-up is needed for reliable assessment of oncological outcomes.