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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 1999 August;12(4):241-6
Minimal morbidity in laparoscopic colorectal surgery. Six years of experience
Morino M., Giraudo G., Festa V., Garrone C., Caldart M.
Backgound. Laparoscopic surgery is gold-standard for many digestive diseases, but at present there is no consensus to treat colorectal diseases by laparoscopy. The authors present their own experience on 180 laparoscopic colorectal procedures performed in 6 years.
Methods. Between April 1992 and April 1998, 180 laparoscopic colorectal procedures (93 for malignant and 87 for benign lesions) were performed in 98 males and 82 females, mean age 63.4 years (range 14-84). With a follow-up ranging from 4 to 76 months an analysis was made of: morbidity and mortality, conversion rate, operative time, hospital stay, patient's comfort and resumption of gastrointestinal function.
Results. The average overall operative time was 162.8 minutes (range 70-600), with a conversion rate to open surgery of 15% (27/180). There was no postoperative mortality at 60 days. The overall morbidity rate was 8.3% (15/180). Resumption of gastrointestinal function was in the 4th postoperative day (range 2-16), nourishment in the 3rd (range 2-16), walking in the 2nd (range 1-20), and mean hospital stay was 8 days (range 3-54). In malignancies group there were 13 deaths (8 for recurrence), 6 cases of metastases and 2 port-site metastases (17 and 28 months after operation, respectively) in 2 cases of advanced rectal cancer.
Conclusions. Laparoscopic colorectal surgery in compliance with oncological rules could offer all the advantages of minimally invasive surgery. Moreover in personal experience there were no mortality and minimal morbidity (8.3%) when compared to the best laparotomic series. Nevertheless it should be reminded that these results were obtained in a very selected group of patients with a short follow-up and by surgeons with a large experience of laparoscopic surgery.