[Value of laparoscopic technique in primary colorectal carcinoma]

Patients who had undergone elective resection for primary colorectal cancer were included in a prospective study. The purpose of the study was to specify the current role of laparoscopic surgery in the treatment of colorectal cancer. Therefore, the reasons for performing the resection conventionally were documented under the general guideline that all colorectal cancer should be resected laparoscopically. Of 111 patients treated in 1995, only 22 underwent a laparoscopic resection and 4 patients a laparoscopic-assisted resection. Age, sex and tumor stage were comparable between groups. Operative time was longer in the laparoscopy group; duration of postoperative ileus and postoperative hospital stay were shorter. The most frequent indications for using a conventional approach were rectal cancer (n = 29), adhesions (n = 15), randomly selected patients (n = 14) and advanced cancer (n = 12). Cardiovascular risk factors were not so important. Laparoscopic techniques were only applied in a minority of patients with colorectal cancer (24-37%). Laparoscopic sphincter-preserving surgery is currently not recommended for rectal cancer in the middle and lower rectum. General risk factors are rarely a contraindication for a laparoscopic approach.