[Laparoscopic surgery of colorectal cancer. Apropos of 103 interventions]

The aim of this study was to assess the feasibility and safety of laparoscopic surgery for the cure of colorectal cancer and to evaluate the oncologic follow-up.

Between March 1993 and December 2000 103 patients with colorectal cancer were treated by laparoscopy. Surgical, pathologic and follow-up data were recorded in a prospective registry database and analyzed by type of resection.

A total of 42 women and 61 men with a mean age of 66.7 years underwent 9 right hemicolectomies, 6 left hemicolectomies, 35 sigmoidectomies, 41 low anterior resections and 12 abdominoperineal resections. Conversion was necessary in 14.5%. Postoperative complications occurred in 21 patients (20.3%) and decreased with experience. Hospital mortality was 0.9%. All cancers (31% stage UICCI, 28% stage II, 37% stage III et 3% stage IV) were resected with tumor-free margins and the mean number of lymph nodes was 19.6. Patients resumed solid diet on the second postoperative day and mean hospitalization was 12.6 days. Three port site recurrences, 4 local recurrences and 10 distant metastases occurred after a mean follow-up of 34.5 months (8-92).

Laparoscopic colorectal cancer surgery is technically feasible with acceptable morbidity and low mortality. An oncologic adequate resection can be performed. To determine whether the recurrence rates and the survival data are equivalent to open surgery, prospective randomized trials are necessary.