engleski

Laparoscopic Colorectal Surgery in Croatia : in spite of Benefits Still Small Uptake

Objective is to assess attitudes in laparoscopic colorectal surgery (LCS) among general (abdominal) surgeons in Croatia. A questionnaire was sent to general surgeons of Croatian Association of Digestive Surgery, Croatian Society for Endoscopic Surgery and Croatian Society of Coloproctology. A total of 121 questionnaires were sent and 102 (84%) surgeons responded. In Croatia almost all general surgeons perform laparoscopic surgery. Each of these surgeons performs an average of 77 laparoscopic procedures per year and nearly all are doing laparoscopic cholecystectomy (97% surgeons). Although first LCS in Croatia was performed 1994., this type of laparoscopic operation is performed by only 25% surgeons. According to obtained data 2600 abdominal colorectal operations is performed per year in Croatia. The average number of abdominal colorectal procedures yearly performed by each surgeon (laparotomy and laparoscopy) is 34 (range 0-200). Each of surgeons performing LCS has average of 7 LCS per year (range 1-35). On average, each of the surgeons who performs LCS has done a total of 22 (range 1-80) laparoscopic colorectal operations. Thirty eight percent of surgeons who perform LCS have done between 1 and 10, 23% have done 11-20, 15% have done 21 - 30 and 23% more than 30 laparoscopic operations. Less than half (40%) of members of Croatian Society for Endoscopic Surgery have performed LCS. The most performed LCS procedure is left hemicolectomy (92%) followed by abdominoperineal resection (76%). Thirty eight percent of surgeons have taken a LCS training course but of these 59% are doing LCS. Surgeons were asked if they would choose to undergo laparoscopic surgery if they had adenoma or colorectal tumor. Eighty eight of the respondents would themselves undergo to LCS for a cecal villous adenoma but 61% would do so for distal-third rectal carcinoma. In Croatia almost all general surgeons perform laparoscopic procedures, mainly laparoscopic cholecystectomy. In spite of 13 years of experinece in LCS the uptake into the surgical community is surprisingly slow. The number of surgeons doing LCS and the number of patients submitted to laparoscopic colorectal operations is slowly increasing year by year. Presently only 25% surgeons are doing LCS.

laparoscopic colorectal surgery

DOI: 10.1007/s00464-009-0402-x