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Laparoscopic colorectal surgery. Analysis of the first 237 cases
W De Mulder1, J P Gillardin, P Hofman
1Department of Surgery, O.L.V. Hospital, Aalst, Belgium.
Acta Chirurgica Belgica
|April 17, 2001
Summary
Laparoscopic colorectal surgery is feasible and safe for various procedures. However, acute diverticulitis cases require caution due to higher complication and conversion rates.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Outcomes
Background:
- Laparoscopic colorectal surgery offers potential benefits over open procedures.
- Assessing the early outcomes of a consecutive series of laparoscopic colorectal surgeries is crucial for establishing safety and feasibility.
Purpose of the Study:
- To prospectively evaluate the results of the first 237 consecutive laparoscopic or laparoscopic-assisted colorectal procedures.
- To analyze patient demographics, indications, complications, and outcomes.
Main Methods:
- Prospective data collection on 237 patients undergoing laparoscopic colorectal procedures between May 1995 and July 1999.
- Analysis of patient gender, age, diagnosis, procedure type, conversion rates, complications, operative time, mortality, and hospital stay.
Main Results:
- A total of 237 procedures were performed, with 151 for benign and 86 for malignant indications.
- The conversion rate to open surgery was 4%, and postoperative complications occurred in 27% of patients, with bowel obstruction being the most common cause.
- Mean hospital stay was 11 days, with a 60-day mortality rate of 2.9%.
Conclusions:
- Laparoscopic colorectal surgery is feasible and safe across a range of procedures and indications.
- Acute diverticulitis is associated with increased complications and conversion rates, necessitating careful consideration.
- While results for malignant cases are promising, long-term data on recurrence and metastasis are needed; curative cancer surgery should remain within prospective studies for most patients.