engleski

Early results and complications of laparoscopic rectal cancer surgery: comparation to open surgery

Aim: The purpose of this paper is to evaluate early results of rectal laparoscopic surgery for cancer and compare with open surgery performed by the same operative team and one senior surgeon. Methods: A review of prospective registry was performed and 41 patients who underwent curative resection for rectal cancer were analyzed. The operative results and short- term outcomes in open and laparoscopy group were compared. Results: From total number of 41 pts, in 15 pts (37%) laparoscopic approach was used. The median age was 69.7 (range 38-87). There was no difference in age, gender, comorbidites and ASA score between open and laparoscopic group. Of 30 patients with low anterior resection (LAR) in 11 pts (36.7%) was performed by laparoscopic approach and from 11 pts submitted for abodminoperineal resection (APR) in 4 (36.3%) cases it was performed laparoscopically. The operating time was longer in laparoscopic group (211, 33 vs 173, 85 min p<0.01). Five patients were converted to open surgery. Majority of conversion (3 pts) were preemptive due to T4 and bulky tumor. Overall intraoperative complications occurred in 5 patients. In laparoscopic group bleeding and ureter lesion were the reasons for conversion to open surgery. Postoperative complications occurred in 8 pts (7 after LAR and 1 after APR). The complications occurred equally in both groups (4 in open and 4 in laparoscopic). Of 3 pts with wound infection 2 underwent open and 1 laparoscopic surgery. Anastomotic leakage was observed in 3 pts (7.31%), and 2 of these patients were submitted to open and 1 to laparoscopic resection. Patients with laparoscopic resection had an earlier return of bowel function as well as shorter median hospital stay (13, 7 vs 15, 6 days). Conclusion: Despite a difficult learning curve and the requirement for significant local service reconfiguration laparoscopic rectal surgery improves the functional outcome and has acceptable morbidity rates comparable with open rectal surgery. This work represents initial experience of one colorectal team and it was not a randomized so further confirmation is required.

laparoscopic rectal surgery

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