Early results of laparoscopic colorectal cancer surgery: 28 patients

Öz

The aim of this study was to report the early results of laparoscopic colorectal resections for colorectal carcinoma. Materials and methods: Patients who had been hospitalized with diagnosis of colorectal cancer between August 2000 and November 2003 were evaluated and early results reported. Results: Conversion rate was 7% (2 of 28 patients). Postoperative complications were observed in 6 patients, and the most frequent was partial intestinal obstruction. One patient was reoperated for intestinal fistula. Median follow-up was 13.5 (3-40) months. During this period, 1 patient developed distant metastasis. No recurrence was detected in port sites, incisions and pelvis. Two patients died during the study period. Conclusion: Laparoscopic colorectal resections can be performed safely and efficiently in centers experienced in laparoscopic techniques and colorectal surgery. None of our patients developed a deleterious effect due to laparoscopy during the follow-up period.

Anahtar Kelimeler

• Laparoscopy, colorectal cancer, early results

Laparoskopik kolorektal kanser cerrahisinin erken dönem sonuçları: 28 olgu

Öz

Bu çalışmamızın amacı kolorektal kanserli olgulara uygulanan laparoskopik rezeksiyonların erken dönem sonuçlarını bildirmektir. Gereç ve yöntem: Türkiye Yüksek İhtisas Hastanesi Gastroenteroloji Cerrahisi Kliniği'ne Ağustos 2000 ile Kasım 2003 tarihleri arası nda kolorektal kanser tanısıyla yatırılan ve laparoskopik rezeksiyon yapı lan 28 olgu değerlendirilmiş ve erken dönem sonuçlar bildirilmiştir. Bulgular: Yirmisekiz olgunun 2 (%7)'sinde konversiyona geçildi. Altı olguda (%21) ameliyat sonrası komplikasyon görüldü. En sık görülen komplikasyon kısmi barsak tıkanmasıydı. Bir olgu intestinal fistül nedeniyle yeniden ameliyat edildi. Serimizin ortanca izlem süresi 13.5 (3-40) ay olup, bu süre esnasında bir olguda uzak metastaz görüldü. Port yerinde, insizyon yerinde ve pelviste nüks saptanmadı. İki olgu eksitus oldu. Sonuç: Laparoskopik kolorektal kanser cerrahisi, laparoskopik ve açık kolorektal cerrahi girişimlerde deneyimli merkezlerde güvenle ve yeterli etkinlikle yapılabilir. İzlemde olgularımızın hiçbirinde laparoskopiye ait olumsuz bir etki görülmemiştir.

Anahtar Kelimeler

• Laparoskopi, kolorektal kanser, erken sonuçlar

Kaynakça

1. Baigrie RJ, Lamont PM, Kwiatkowski D, et al. Systemic cytokine response after major surgery. Br J Surg 1992; 79: 757-60.
2. Cruickshank AM, Frase WD, Burns HJ, et al. Response of serum in- terleukin-6 in patients undergoing elective surgery of varying seve- rity. Clin Sci 1990; 79: 161-5.
3. Delgado S, Lacy AM, Filella X, et al. Acute phase response in lapa- roscopic and open colectomy in colon cancer: randomized study. Dis Colon Rectum 2001; 44: 638-46.
4. Leung KL, Kwok SP, Lau WY, et al. Laparoscopic-assisted abdomi- noperineal resection for low rectal adenocarcinoma. Surg Endosc 2000; 14: 67-70.
5. Braga M, Vignali A, Gianotti L, et al. Laparoscopic versus open co- lorectal surgery: A randomized trial on short-term outcome. Ann Surg 2002; 236: 759-66.
6. Senagore AJ, Delaney CP. A critical analysis of laparoscopic colec- tomy at a single institution: lessons learned after 1000 cases. Am J Surg 2006; 191: 377-80.
7. Martel G, Boushey RP. Laparoscopic colon surgery: past, present and future. Surg Clin North Am 2006; 86: 867-97.
8. Hong D, Tabet J, Anvari M. Laparoscopic vs. open resection for co- lorectal adenocarcinoma. Dis Colon Rectum 2001; 44: 10-8.

9. Lezoche E, Feliciotti F, Paganini AM, et al. Laparoscopic vs open hemicolectomy for colon cancer. Surg Endosc 2002; 16: 596-602.
10. Senagore AJ, Luchtefeld MA, Mackeigan JM. What is the learning curve for laparoscopic colectomy?. Am Surg 1995; 61: 681-5.
11. Agachan F, Joo JS, Sher M, et al. Laparoscopic colorectal surgery. Do we get faster? Surg Endosc 1997; 11: 331-5.
12. Wishner JD, Baker JW Jr, Hoffman GC, et al. Laparoscopic-assis- ted colectomy. The learning curve. Surg Endosc 1995; 9: 1179-83.
13. Schlachta CM, Mamazza J, Seshadri PA, et al. Defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 2001; 44: 217-22.
14. Meijer DW, Bannenberg JJ, Jakimowicz JJ. Hand-assisted laparos- copic surgery: an overview. Surg Endosc 2000; 14: 891-5.
15. Sjoerdsma W, Meijer DW, Jansen A, den Boer KT, et al. Compari- son of efficiencies of three techniques for colon surgery. J Laparo- endosc Adv Surg Tech A 2000; 10: 47-53.
16. Kockerling F, Scheidbach H, Schneider C, et al. Laparoscopic ab- dominoperineal resection: early postoperative results of a prospec- tive study involving 116 patients. The Laparoscopic Colorectal Sur- gery Study Group. Dis Colon Rectum 2000; 43: 1503-11.