Skip to main content
PMC home page
Annals of Surgery logoLink to Annals of Surgery
. 1996 Feb;223(2):170–176. doi: 10.1097/00000658-199602000-00009

Prospective evaluation of laparoscopic-assisted large bowel excision for cancer.

S P Kwok 1, W Y Lau 1, P D Carey 1, S B Kelly 1, K L Leung 1, A K Li 1
PMCID: PMC1235093  PMID: 8597511

Abstract

OBJECTIVE: The authors described their experience with laparoscopic-assisted colorectal resection for colorectal carcinoma, both curative and palliative, with emphasis on patient selection. The techniques of the operations were described. SUMMARY BACKGROUND DATA: Laparoscopic colorectal procedures for treatment of benign lesions have been shown to be less painful and to enhance early postoperative recovery. However, use of laparoscopic procedures for treatment of colorectal cancer are controversial. The authors have used laparoscopic techniques for curative and palliative resections of colorectal carcinoma with satisfactory early results. METHODS: One hundred patients with colorectal carcinoma were selected over a 30-month period for laparoscopic-assisted colorectal resection. For 17 patients, laparoscopy revealed bulky tumor or locally advanced disease, and open surgery was performed. For 83 patients, laparoscopic-assisted colon and rectal resections were attempted. Procedural data and postoperative results were entered prospectively. The median follow-up period was 15.2 months (range, 2.5-32.7 months). RESULTS: Fourteen of 83 patients eventually required conversion to open surgery. The median operative time was 180 minutes. The patients could return to a normal diet in a median of 4 days. The median number of doses of analgesics required was two, and the median hospital stay was 6 days. The morbidity rate was 12%, and there was no deaths attributable to the procedure. There were four distant recurrences and one pelvic recurrence. CONCLUSIONS: Laparoscopic-assisted colorectal resection for selected patients is feasible, and early postoperative results are encouraging. This procedure does not appear to be associated with an excessive recurrence rate, and long-term follow-up is necessary for late survival figures.

Full text

PDF
172

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Beart R. W., Jr Laparoscopic colectomy: status of the art. Dis Colon Rectum. 1994 Feb;37(2 Suppl):S47–S49. doi: 10.1007/BF02048431. [DOI] [PubMed] [Google Scholar]
  2. Binderow S. R., Cohen S. M., Wexner S. D., Nogueras J. J. Must early postoperative oral intake be limited to laparoscopy? Dis Colon Rectum. 1994 Jun;37(6):584–589. doi: 10.1007/BF02050994. [DOI] [PubMed] [Google Scholar]
  3. Böhm B., Milsom J. W., Kitago K., Brand M., Fazio V. W. Laparoscopic oncologic total abdominal colectomy with intraperitoneal stapled anastomosis in a canine model. J Laparoendosc Surg. 1994 Feb;4(1):23–30. doi: 10.1089/lps.1994.4.23. [DOI] [PubMed] [Google Scholar]
  4. Darzi A., Super P., Guillou P. J., Monson J. R. Laparoscopic sigmoid colectomy: total laparoscopic approach. Dis Colon Rectum. 1994 Mar;37(3):268–271. doi: 10.1007/BF02048165. [DOI] [PubMed] [Google Scholar]
  5. Dean P. A., Beart R. W., Jr, Nelson H., Elftmann T. D., Schlinkert R. T. Laparoscopic-assisted segmental colectomy: early Mayo Clinic experience. Mayo Clin Proc. 1994 Sep;69(9):834–840. doi: 10.1016/s0025-6196(12)61784-4. [DOI] [PubMed] [Google Scholar]
  6. Decanini C., Milsom J. W., Böhm B., Fazio V. W. Laparoscopic oncologic abdominoperineal resection. Dis Colon Rectum. 1994 Jun;37(6):552–558. doi: 10.1007/BF02050989. [DOI] [PubMed] [Google Scholar]
  7. Falk P. M., Beart R. W., Jr, Wexner S. D., Thorson A. G., Jagelman D. G., Lavery I. C., Johansen O. B., Fitzgibbons R. J., Jr Laparoscopic colectomy: a critical appraisal. Dis Colon Rectum. 1993 Jan;36(1):28–34. doi: 10.1007/BF02050298. [DOI] [PubMed] [Google Scholar]
  8. Geis W. P., Coletta A. V., Verdeja J. C., Plasencia G., Ojogho O., Jacobs M. Sequential psychomotor skills development in laparoscopic colon surgery. Arch Surg. 1994 Feb;129(2):206–212. doi: 10.1001/archsurg.1994.01420260102014. [DOI] [PubMed] [Google Scholar]
  9. Gray D., Lee H., Schlinkert R., Beart R. W., Jr Adequacy of lymphadenectomy in laparoscopic-assisted colectomy for colorectal cancer: a preliminary report. J Surg Oncol. 1994 Sep;57(1):8–10. doi: 10.1002/jso.2930570104. [DOI] [PubMed] [Google Scholar]
  10. Jakeways M. S., Mitchell V., Hashim I. A., Chadwick S. J., Shenkin A., Green C. J., Carli F. Metabolic and inflammatory responses after open or laparoscopic cholecystectomy. Br J Surg. 1994 Jan;81(1):127–131. doi: 10.1002/bjs.1800810146. [DOI] [PubMed] [Google Scholar]
  11. Jamieson G. G., Watson D. I., Britten-Jones R., Mitchell P. C., Anvari M. Laparoscopic Nissen fundoplication. Ann Surg. 1994 Aug;220(2):137–145. doi: 10.1097/00000658-199408000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Kloosterman T., von Blomberg B. M., Borgstein P., Cuesta M. A., Scheper R. J., Meijer S. Unimpaired immune functions after laparoscopic cholecystectomy. Surgery. 1994 Apr;115(4):424–428. [PubMed] [Google Scholar]
  13. Köckerling F., Gastinger I., Schneider B., Krause W., Gall F. P. Laparoscopic abdominoperineal excision of the rectum with high ligation of the inferior mesenteric artery in the management of rectal carcinoma. Endosc Surg Allied Technol. 1993 Feb;1(1):16–19. [PubMed] [Google Scholar]
  14. Lyerly H. K., Mault J. R. Laparoscopic ileostomy and colostomy. Ann Surg. 1994 Mar;219(3):317–322. doi: 10.1097/00000658-199403000-00013. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Monson J. R., Darzi A., Carey P. D., Guillou P. J. Prospective evaluation of laparoscopic-assisted colectomy in an unselected group of patients. Lancet. 1992 Oct 3;340(8823):831–833. doi: 10.1016/0140-6736(92)92694-b. [DOI] [PubMed] [Google Scholar]
  16. Nduka C. C., Monson J. R., Menzies-Gow N., Darzi A. Abdominal wall metastases following laparoscopy. Br J Surg. 1994 May;81(5):648–652. doi: 10.1002/bjs.1800810506. [DOI] [PubMed] [Google Scholar]
  17. O'Rourke N. A., Heald R. J. Laparoscopic surgery for colorectal cancer. Br J Surg. 1993 Oct;80(10):1229–1230. doi: 10.1002/bjs.1800801004. [DOI] [PubMed] [Google Scholar]
  18. Perissat J., Vitale G. C. Laparoscopic cholecystectomy: gateway to the future. Am J Surg. 1991 Mar;161(3):408–408. doi: 10.1016/0002-9610(91)90609-h. [DOI] [PubMed] [Google Scholar]
  19. Phillips E. H., Franklin M., Carroll B. J., Fallas M. J., Ramos R., Rosenthal D. Laparoscopic colectomy. Ann Surg. 1992 Dec;216(6):703–707. doi: 10.1097/00000658-199212000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Plasencia G., Jacobs M., Verdeja J. C., Viamonte M., 3rd Laparoscopic-assisted sigmoid colectomy and low anterior resection. Dis Colon Rectum. 1994 Aug;37(8):829–833. doi: 10.1007/BF02050150. [DOI] [PubMed] [Google Scholar]
  21. Tate J. J., Kwok S., Dawson J. W., Lau W. Y., Li A. K. Prospective comparison of laparoscopic and conventional anterior resection. Br J Surg. 1993 Nov;80(11):1396–1398. doi: 10.1002/bjs.1800801113. [DOI] [PubMed] [Google Scholar]
  22. Wexner S. D., Johansen O. B., Nogueras J. J., Jagelman D. G. Laparoscopic total abdominal colectomy. A prospective trial. Dis Colon Rectum. 1992 Jul;35(7):651–655. doi: 10.1007/BF02053755. [DOI] [PubMed] [Google Scholar]
  23. Zucker K. A., Pitcher D. E., Martin D. T., Ford R. S. Laparoscopic-assisted colon resection. Surg Endosc. 1994 Jan;8(1):12–18. doi: 10.1007/BF02909486. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES