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Laparoscopic-assisted colorectal surgery. Lessons learned from 240 consecutive patients
J W Lumley1, G A Fielding, M Rhodes
1Department of Surgery, Royal Brisbane Hospital, Herston, Australia.
Diseases of the Colon and Rectum
|February 1, 1996
Summary
Laparoscopic colorectal surgery at Royal Brisbane Hospital showed reduced wound infections compared to open surgery. Overall morbidity and mortality were acceptable, indicating a safe and effective approach for colorectal conditions.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Procedures
- Surgical Audit
Background:
- Laparoscopic-assisted colectomy has been performed for over 300 patients since 1991.
- This study focuses on the outcomes of the initial 240 laparoscopic colorectal procedures.
Purpose of the Study:
- To audit the development and outcomes of laparoscopic colorectal surgery.
- Evaluate the safety and efficacy of laparoscopic colorectal procedures at a specific institution.
Main Methods:
- Prospective data collection for 240 laparoscopic colorectal procedures.
- Comparison of laparoscopic outcomes with historical open surgical controls.
- Analysis of complication rates including wound infections, anastomotic leaks, and postoperative obstructions.
Main Results:
- A significant reduction in wound infection rates was observed in laparoscopic-assisted colectomy patients (3.6%) compared to historical controls (7.9%).
- Nineteen patients (7.9%) required conversion to open surgery.
- Five anastomotic leaks, five laparotomies for adhesive obstruction, and four perioperative deaths occurred.
- For colorectal cancer procedures, 5 recurrences (6.3%) were noted among 79 potentially curative operations.
Conclusions:
- Laparoscopic colorectal surgery demonstrated acceptable morbidity and mortality rates when compared to open procedures.
- The findings support the use of laparoscopic techniques for colorectal disease management.