[Minimally aggressive surgery in advanced cancer of the colon]

We evaluated minimally aggressive surgery in the treatment of metastasic cancer of the colon in 6 patients: 2 females and 4 males, with an average age of 71.8. Preoperative studies showed cancer of the colon (right colon = 4; sigmoid colon = 2) with multiple hepatic metastasis. In all cases laparoscopic mobilization and extracorporeal resection with end-to-end anastomosis was performed employing a biofragmentable anastomotic ring. In two patients laparoscopy discovered peritoneal carcinomatosis. One patient was operated using conventional surgery. Intestinal segments with an average length of 21.3 cm were removed, with a mean of 13.5 lymph-nodes per patient, 70.3% of which had metastasis. Eleven of the 12 resection lines were tumor-free (91.6%). Hospital stay averaged 7.8 days, and mean survival has been 4.5 months. Only two patients, those with peritoneal carcinomatosis, had post-operative complications. If an appropriate patient selection is followed: cancer of the colon with hepatic metastasis and no peritoneal spread, laparoscopic surgery is a reliable and effective treatment for advaned cancer of the colon.