[Laparoscopy-assisted colon resection. A prospective study with short-term results and 12-38 months' follow-up]

Despite several reports demonstrating its clinical benefits, laparoscopy-assisted colectomy (LAC) has not gained universal acceptance because of its oncologic implications. In this article we present our experiences with LAC.

A consecutive series of 75 patients undergoing LAC between February 2001 and March 2003 was followed. Fifty-nine of the patients had colon cancer. Standardized postoperative care procedures were used. The median follow-up time for the colon cancer patients was 19 months (range 12-38 months).

The median operation time was 190 minutes (range 150-300 minutes). Two patients (3%) required a conversion to laparotomy. Ten patients (13%) suffered from postoperative complications. The postoperative mortality rate was 3%. The median length of stay for the patients who were directly discharged to their home was 4 days (range 1-30 days). There were no readmissions in the postoperative period. Fifty-five patients with malignancy underwent curative resection, while four, who had metastatic disease, were operated on for palliation. The frequency of recurrence and the cancer-related mortality rate in the follow-up period were both 21%. No significant differences were found between patients with Dukes' type B and type C with regard to being free of recurrence or cancer-related survival. One port-site recurrence (2%) occurred in the patients who underwent curative resection.

Our results shows that LAS has clinical advantages, especially in the short term, and provides better oncologic results than open surgery, especially in cases of Dukes' type C cancer. LAC for cancer should be performed by experienced hands and monitored adequately by a national register to ensure satisfactory oncologic outcomes.