Laparoscopic surgery for colon and rectal cancer.

ABSTRACT

Use of laparoscopic resection for colorectal malignancy has raised concerns regarding local cancer control and the lack of long-term results. Most reported data are preliminary and medium-term results, at best. The aim of this study is to analyse all patients who underwent a laparoscopic resection for colorectal cancer at our department between November 1992 and July 2003. The cohort comprised a total of 394 patients (194 rectal cancer and 200 colon carcinoma). The most common procedures were high and low anterior resection with total mesorectum excision (TME) (176), followed by sigmoidectomy (89), right hemicolectomy (57), and left hemicolectomy (42). Mean operating time was 176 minutes. Conversion was necessary in 4 of the patients. Mean number of lymph nodes removed was 27. The postoperative complication rate was 20.1% (rectum) and 12.5% (colon). One patient died of myocardial infarction. Mean follow up was 45 (0.3-135) months. Port site metastasis occurred in 2 patients. The local recurrence rate was 4.1% after curative rectum resection and 0.5% in the colon group. After curative resection, the overall 5-year survival rate was 76.9% (rectum), and 81.4% (colon). Cancer-related survival rate after 5 years was 87.7% (rectum), and 91.3% (colon). Our results demonstrate that laparoscopic resection for colorectal cancer is not associated with higher morbidity and mortality rates. Established oncological principles are respected and long-term results are at least as good as those after open surgery.