Laparoscopic resection for colorectal cancer.

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Colorectal Surgery

Background:

• Assessing the role of laparoscopic surgery in colorectal cancer resection.
• Evaluating the feasibility and outcomes of a single surgeon's practice over time.

Purpose of the Study:

• To determine the place of laparoscopic colorectal cancer surgery within a surgeon's practice.
• To analyze trends in suitability, conversion, and outcomes for laparoscopic colorectal cancer resection.

Main Methods:

• Prospective study of 365 patients undergoing elective colorectal cancer resection.
• Analysis of early, middle, and late cohorts (1994-2005) based on suitability for laparoscopic surgery, conversion rates, and outcomes.

Main Results:

• The proportion of attempted laparoscopic resections increased significantly over time (35.6% to 80.6%).
• Suitability for laparoscopic resection also increased, reaching 94.0% in the late cohort.
• Independent predictors for conversion included rectal cancer surgery and higher body mass index; conversion rate in the late cohort was 8.7% after excluding specific cases.

Conclusions:

• Laparoscopic colorectal cancer surgery is feasible in approximately 90% of elective resections with increasing surgeon experience.
• The study demonstrates a growing proficiency and applicability of minimally invasive techniques for colorectal cancer.