ORIGINAL ARTICLE   

Chirurgia 2017 April;30(2):50-4

DOI: 10.23736/S0394-9508.16.04614-3

Copyright © 2016 EDIZIONI MINERVA MEDICA

lingua: Inglese

Laparoscopic resection of colorectal carcinoma: a comparative study of an initial experience

Francesco TATULLI, Antonio CAPUTI, Angelo CARAGLIA, Annarita NOTARNICOLA, Felice CARBONE, Nicola CHETTA, Teresa RUGGIERI, Giuseppe CHETTA ✉

General Surgery Unit, V. Emanuele II Hospital, Bisceglie, Barletta-Andria-Trani, Italy

BACKGROUND: Laparoscopic resection of colorectal carcinoma has not gained yet widespread acceptance unlike other common laparoscopic procedures, such as cholecystectomy, antireflux operations or solid organ removal. The aim of this study was to retrospectively make a comparison of 38 patients undergoing elective laparoscopic resection with 38 elective open colorectal resections for colorectal carcinoma matched for 3 tumor variables: location, TNM stage and size.
METHODS: Thirty-eight patients undergoing elective laparoscopic resections for colorectal carcinoma (LR, group A) were compared with 38 elective open resections (OR, group B). Controls were matched for 3 tumor variables: location, TNM stage and size. Fourteen factors were investigated pertaining to the patients’ demographic and clinical characteristics (age, gender, preoperative ASA score), operation-related data (types of operation, duration of operation, stoma creation), tumor-related data (proximal and distal margins, harvested lymph nodes, LNs), and outcome measures (passage of gas, transfusion requirement, postoperative length of stay, complications, mortality). The resulting data were recorded in a Microsoft Access 2007 database.
RESULTS: No difference was observed regarding age and gender distribution, types of operations and stomas, complications. Group A showed prevalent lower ASA scores, earlier passage of flatus, shorter postoperative stay, the single death of the whole population. In group B operative time was shorter, more lymph nodes were retrieved, proximal margins were longer, more transfusions were required.
CONCLUSIONS: Laparoscopic surgery for colorectal carcinoma was associated with better recovery than OR, but this technique still has a margin for improvement, in terms of both clinical and administrative aspects.

KEY WORDS: Laparoscopy - Colorectal neoplasms - Colorectal surgery