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Laparoscopic palliative surgery for complicated colorectal cancer
R Gonzalez1, C D Smith, E M Ritter
1Emory Endosurgery Unit, Emory University School of Medicine, 1364 Clifton Road, NE, Atlanta, GA 30322, USA.
Background:
The aim of this study was to evaluate the feasibility and outcomes of the laparoscopic approach for the palliation of advanced complicated colorectal cancer (CRC).
Methods:
We reviewed 21 laparoscopic palliative procedures for emergent complications of advanced CRC between 1994 and 2002. Intraoperative complications, estimated blood loss, transfusions, operative times, time to first bowel movement, length of hospital stay, and postoperative complications were assessed.
Results:
Indications for surgery included perforation (n = 10), bleeding (n = 7), and obstruction (n = 4). A proximal diverting procedure was performed in all patients, and a concomitant colon resection was performed in 18 patients (86%). The mean operative time was 181 +/- 22 min. Estimated blood loss was 283 +/- 48 cc, with three patients (14%) requiring transfusions. The average length of hospital stay was 8.6 +/- 2 days, and time to first bowel movement was 61 +/- 9 h. The complication rate and the 30-day mortality rate were 33% and 0%, respectively.
Conclusion:
A laparoscopic approach to address advanced CRC is safe and effective and should be considered part of the surgeon's armamentarium for the palliation of advanced complicated CRC.