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Experience with laparoscopic colorectal surgery for malignant disease
P J Guillou1, A Darzi, J R Monson
1Academic Surgical Unit, Imperial College of Science, Technology & Medicine, St. Mary's Hospital Medical School, London, UK.
Surgical Oncology
|January 1, 1993
Summary
Laparoscopic surgery for colorectal cancer is feasible, showing comparable resection margins and lymph node yield to open surgery. Further research is needed on thrombo-embolic prophylaxis and long-term recurrence rates before widespread adoption.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
Background:
- Colorectal cancer treatment traditionally involves open surgery.
- Laparoscopic techniques offer potential benefits in minimally invasive surgery.
Purpose of the Study:
- To evaluate the feasibility and early outcomes of laparoscopic or laparoscopic-assisted surgery for colorectal cancer.
- To compare surgical outcomes with conventional open surgery.
Main Methods:
- A prospective study of 59 patients undergoing laparoscopic or laparoscopic-assisted surgery for colorectal cancer.
- Data collected on conversion rates, mortality, recurrence, resection margins, and lymph node yield.
Main Results:
- Conversion to open surgery occurred in 8.4% of patients.
- Perioperative mortality was 5.8%, with thrombo-embolic complications being a factor in two deaths.
- Cancer-related mortality was 8%, with all recurrences observed in Dukes' C stage patients.
- Resection margins and lymph node yield were comparable to open surgery.
Conclusions:
- Laparoscopic-assisted resection of colorectal cancer is feasible without compromising surgical principles.
- Further investigation is required for thrombo-embolic prophylaxis, specimen retrieval, and long-term recurrence rates.