腹腔镜与开腹结直肠癌根治术近期疗效对比

目的分析对比腹腔镜与开腹结直肠癌根治术的近期疗效。方法回顾性分析我院2010年1月~2013年10月收治的120例结直肠癌患者的临床资料,其中腹腔镜手术组62例,开腹手术组58例。观察对比两组患者手术时间、出血量、肠蠕动时间、平均住院时间、术后恢复情况及并发症情况,并对肿瘤根治的有效性及安全性给予分析。结果两组患者均成功完成手术,无死亡病例。腹腔镜手术组手术时间长于开腹手术组(P0.05);术中出血量、术后引流量少于开腹手术组(P0.05);切口长度短于开腹手术组(P0.05);排气时间及住院时间短于开腹手术组(P0.05)。腹腔镜手术组术后并发症发生率为4.8%,明显低于开腹手术组的17.2%(P0.05)。结论腹腔镜根治性治疗结直肠癌是一种安全、微创、有效的手术方式,近期疗效满意,且具有创伤小、疼痛轻、恢复快、住院时间短等优点,值得临床广泛推广应用。     

腹腔镜结直肠癌根治术手术技术的探讨

目的:探讨腹腔镜结直肠癌根治术的手术技术,包括手术的整体配合、手术路径等.方法:回顾分析为60例结直肠癌患者施行腹腔镜结直肠癌根治术的全过程.结果:60例均顺利完成腹腔镜手术,无一例中转开腹.其中直肠癌根治术35例,包括Miles术式5例,直肠癌晚期姑息性乙状结肠造瘘2例,直肠腺瘤局部肠管切除1例,结肠癌根治术20例,...     

腹腔镜辅助结直肠癌根治术的临床应用

目的：探讨腹腔镜辅助结直肠癌根治术的可行性、安全性及近期疗效。方法：回顾分析2007年8月至2009年6月施行的32例腹腔镜辅助结直肠癌根治术的临床资料。其中右半结肠切除术5例,横结肠切除术1例,左半结肠切除术7例,乙状结肠切除术5例,结肠次全切除术1例,直肠癌行Dixon手术7例,Miles手术6例。结果：除2例中转开腹外,余30例均在腹腔镜辅助下顺利完成手术,无手术死亡病例;结肠癌切除包括肿块在内的12~23cm肠管;直肠癌行Dixon术或Miles术时,下端切缘距肿瘤下缘3~5cm,术后病理证实所有标本残端均无肿瘤细胞残留、浸润。手术时间130~248min,平均152min;术中出血90~320ml,平均160ml;术后肠蠕动恢复时间36~72h,平均48h;淋巴结清扫4~22枚,平均12.6枚。术后无出血、吻合口瘘和狭窄等并发症发生,术后仅1例切口感染,2个月后再次清创缝合后痊愈;术后住院5~9d,平均7.2d;术后电话随访至2010年2月,死亡1例,局部复发1例,余患者随访期内均未发现转移、复发及切口种植。结论：腹腔镜辅助结直肠癌手术具有患者创伤小、操作安全、术后康复快等优点,不仅技术上可行,而且完全可取得与传统开腹手术同样的治疗效果。     

腹腔镜结直肠癌根治术的可行性及近期疗效分析

目的:探讨腹腔镜结直肠癌根治术的可行性及近期临床疗效。方法:回顾分析2010年3月至2013年10月92例结直肠癌患者的临床资料,其中28例行腹腔镜手术,64例行传统开腹手术,对比分析两组患者术中出血量、切口总长度、肛门首次排气时间、人均止痛次数、术后下床活动时间、住院时间、手术时间、术后并发症等指标。结果:腹腔镜组术中出血量、切口总长度、肛门首次排气时间、人均止痛次数、术后下床活动时间、住院时间优于开腹组,差异有统计学意义(P<0.05)。清除淋巴结数量、术后并发症两组差异无统计学意义(P>0.05),但腹腔镜组术后并发症发生率低于开腹组,腹腔镜手术时间长于开腹手术。结论:腹腔镜结直肠癌根治术具有患者创伤小、康复快、住院时间短等优点,其手术疗效与开腹手术相当,值得临床推广应用。其适应证的掌握是循序渐进的过程,随着学习曲线的完成、技术水平的完善、手术经验的积累及腔镜设备的改进,手术适应证会逐步扩大。     

腹腔镜结直肠癌根治术的临床体会

目的:探讨腹腔镜结直肠癌根治术的临床效果。方法:回顾分析2011年3月至10月为26例结直肠癌患者行腹腔镜结直肠癌根治术的临床资料,并总结手术方式及随访结果。结果:手术时间105～315 min,平均185 min;术中出血量100～320 ml,平均175 ml;术后胃肠功能恢复时间1～4 d,平均1.8 d;标本切缘均阴性,清扫淋巴结总数10～22枚,平均15枚。术后未发生腹腔出血、吻合口漏及狭窄等并发症;术后住院7～10 d,平均8 d。随访3～10个月,平均8个月,均无转移、复发及切口种植。结论:腹腔镜结直肠癌根治术安全可行,具有微创、安全、术后康复快、肿瘤根治彻底等优点,在肿瘤根治性、手术时间、近期疗效等方面与传统开腹手术相当,值得推广应用。     

腹腔镜辅助与开腹结直肠癌根治术临床对比研究

目的对比研究腹腔镜辅助与开腹结直肠癌根治术的安全性及根治疗效。方法选取2010年2月至2012年2月结直肠的患者252例,前瞻性非随机(根据患者意愿)将入选病例分为腹腔镜组(143例)及开腹组109例。将所得数据采用SPSS 19.0软件检验分析。术前、术后指标、肿瘤大小、结肠标本的大小、直肠标本的大小、直肠下切端距离及淋巴结清扫枚数采用x珋±s表示并用t检验,近期并发症、复发率、转移率及远期并发症采用率表示并用χ~2检验,检验标准α=0.05,P0.05则具有统计学意义。结果腹腔镜的手术时间长于开腹组[(156.8±52.3)min比(143.5±41.9)min,t=2.187,P0.05]。腹腔组的术中失血、术后排气时间、术后下床时间、术后进食流食时间及术后住院时间的指标优于开腹组[(83.8±26.7)ml比(173.2±39.5)ml,(2.2±0.7)d比(3.9±0.9)d,(2.4±0.6)d比(3.2±1.1)d,(3.0±0.8)d比(4.3±0.9)d,(6.8±1.3)d比(8.9±1.6)d,t=21.368,t=16.867,t=7.349,t=12.123,t=11.496,P0.05]。两组术后近期并发症、切除的肿瘤大小、结肠标本的大小、直肠标本的大小、直肠下切端距离及淋巴结清扫枚数、局部复发率、远处转移率、术后远期并发症发生率及3年生存率差异无统计学意义(P0.05)。结论本研究腹腔镜结直肠癌手术具有开腹手术相同的手术安全性及肿瘤根治效果,近期疗效优于开腹手术,远期疗效与开腹手术无显著差异。     

腹腔镜在结直肠癌根治术中的应用

目的 探讨腹腔镜结直肠癌根治术的临床应用价值.方法 回顾分析31例腹腔镜下结直肠癌根治术的临床病例资料.结果 除1例中转开腹外,其余30例均在腹腔镜下完成手术;其中右半结肠切除术8例、左半结肠切除术4例、乙状结肠切除术5例、直肠癌行直肠前切除术8例、Miles术6例.手术时间150～300 min(平均200 min)...     

腹腔镜结直肠癌根治术疗效分析

目的 探讨腹腔镜结直肠癌根治术的疗效.方法 比较2000年9月至2004年12月福建医科大学附属协和医院收治的99例腹腔镜结直肠癌根治术(腹腔镜组)患者和198例开腹结直肠癌根治术(开腹组)患者局部复发及生存情况的差异.两组各随访时间段的局部复发率、生存率计算采用寿命表法,局部复发率及生存率的比较采用Wilcoxon(Gehan)检验或X2检验及Fisher确切概率法,复发间隔时间、生存时间的比较均采用非参数Wilcoxan秩和检验.结果 腹腔镜组2、3年局部复发率均为3.0%,总的局部复发率3.0%(3/99);开腹组2、3年局部复发率分别为2.6%和4.0%,总的局部复发率为3.5%(7/198),两组局部复发率比较差异无统计学意义(χ2=0.002,P>0.05).两组局部复发的患者中位生存时间分别为15个月(7～24个月)和11个月(2～28个月),差异无统计学意义(U-15.500,P>0.05).两组局部复发的患者1年生存率分别为33.3%和42.9%,2年生存率分别为0和42.9%,差异无统计学意义(χ2=0.120,P>0.05).结论 腹腔镜结直肠癌根治术与开腹结直肠癌根治术有同样的疗效,且安全可行,不会增加肿瘤的复发率.     

腹腔镜结直肠癌根治术疗效分析

Objective To investigate the efficacy of laparoscopic radical resection for colorectal cancer. Methods From September 2000 to December 2004, 99 patients with colorectal cancer underwent laparoscopic radical resection (laparoscopic group) and 198 patients with colorectal cancer underwent open radical resection (open group) at the Union Hospital of Fujian Medical University. The differences in local recurrence and survival between the two groups were compared. The local recurrence of tumors and survival of patients in the two groups were calculated by the life-table method, and were compared by the Wilcoxon (Gehan) test, chi-square test and Fisher's exact test. The recurrence interval and survival time of the two groups were compared by non-parametric Wilcoxon rank sum test. Results The 2-and 3-year local recurrence rates in the laparoscopic group were both 3.0% and the overall local recurrence rate was 3.0% (3/99). The 2-and 3-year local recurrence rates in the open group were 2.6% and 4.0% , respectively, and the overall local recurrence rate was 3.5% (7/198), with no significant difference between the two groups (χ2 =0.002, P > 0. 05). The median survival time of patients with local recurrence was 15 months (range, 7-24 months) in the laparoscopic group and 11 months (range, 2-28 months) in the open group, with no significant difference between the groups (U = 15. 500, P >0. 05). The 1-year survival rate was 33.3% in the laparoscopic group and 42.9% in the open group. The 2-year survival rate was zero in the laparoscopic group and 42. 9% in the open group. There were no significant differences between the groups for the 1-and 2-year survival rates (χ2 =0.120, P>0.05). Conclusions The efficacy of laparoscopic radical resection for colorectal cancer is similar to that of open surgery. Laparoscopic radical resection for colorectal cancer is safe and feasible, and does not increase the recurrence rate of cancer.     

腹腔镜结直肠癌根治术疗效分析

Objective To investigate the efficacy of laparoscopic radical resection for colorectal cancer. Methods From September 2000 to December 2004, 99 patients with colorectal cancer underwent laparoscopic radical resection (laparoscopic group) and 198 patients with colorectal cancer underwent open radical resection (open group) at the Union Hospital of Fujian Medical University. The differences in local recurrence and survival between the two groups were compared. The local recurrence of tumors and survival of patients in the two groups were calculated by the life-table method, and were compared by the Wilcoxon (Gehan) test, chi-square test and Fisher's exact test. The recurrence interval and survival time of the two groups were compared by non-parametric Wilcoxon rank sum test. Results The 2-and 3-year local recurrence rates in the laparoscopic group were both 3.0% and the overall local recurrence rate was 3.0% (3/99). The 2-and 3-year local recurrence rates in the open group were 2.6% and 4.0% , respectively, and the overall local recurrence rate was 3.5% (7/198), with no significant difference between the two groups (χ2 =0.002, P > 0. 05). The median survival time of patients with local recurrence was 15 months (range, 7-24 months) in the laparoscopic group and 11 months (range, 2-28 months) in the open group, with no significant difference between the groups (U = 15. 500, P >0. 05). The 1-year survival rate was 33.3% in the laparoscopic group and 42.9% in the open group. The 2-year survival rate was zero in the laparoscopic group and 42. 9% in the open group. There were no significant differences between the groups for the 1-and 2-year survival rates (χ2 =0.120, P>0.05). Conclusions The efficacy of laparoscopic radical resection for colorectal cancer is similar to that of open surgery. Laparoscopic radical resection for colorectal cancer is safe and feasible, and does not increase the recurrence rate of cancer.     

Impact of conversion on the long-term outcome in laparoscopic resection of colorectal cancer

Background  Long-term outcome of patients with conversion following laparoscopic resection of colorectal cancer has seldom been reported. This study aimed to evaluate the impact of conversion on the operative outcome and survival of patients who underwent laparoscopic resection for colorectal malignancy. Methods  An analysis of a prospectively collected database of 470 patients who underwent laparoscopic colectomy between May 2000 and December 2006 was performed. The operative results and long-term outcomes of patients with conversion were compared with those with successful laparoscopic operations. Results  The overall conversion rate to open surgery was 8.7% (41 patients). There was no difference in age, comorbid illness, location of tumor, and stage of disease between the laparoscopic and conversion groups. The most common reasons for conversion include adhesions (34.1%), tumor invasion into adjacent structures (17.1%), bulky tumor (9.8%), and uncontrolled hemorrhage (9.8%). A male preponderance was observed in the conversion group. Tumor size was significantly larger in the conversion group compared with the laparoscopic group (5 versus 4 cm, P = 0.002). Although there was no difference in the operative time between the two groups, increased perioperative blood loss (461.9 vs. 191.2 ml, P < 0.001), increased postoperative complication rate (56.1% versus 16.7%, P = 0.001) and prolonged median hospital stay (10 versus 6 days, P < 0.001) were associated with the conversion group. Consequently, patients in the conversion group were more likely to develop local recurrence (9.8% versus 2.8%, P < 0.001) with a significantly reduced cumulative cancer-free survival. Conclusion  The disease-free survival and the local recurrence were significantly worse by the presence of conversion in laparoscopic resection for colorectal malignancy. Adoption of a standardized operative strategy may improve the perioperative outcome after conversion.     

65岁以上老年患者腹腔镜结直肠癌手术的短期疗效观察

目的:比较为65岁以上老年患者行腹腔镜与开腹结直肠癌切除术的短期疗效。方法:将2012年1月至2014年9月收治的162例结直肠癌患者分为腹腔镜组(n=67)与开腹组(n=95),比较术前临床资料、术中及术后指标。结果:腹腔镜组与开腹组术前临床资料、清扫淋巴结数量差异无统计学意义(P0.05);腹腔镜组切口长度、术中出血量、首次下床活动时间、肛门排气时间、并发症发生率、术后住院时间优于开腹组(P0.05)。结论:为65岁以上的老年患者行腹腔镜结直肠癌切除术是有效、安全、可行的,与开腹手术相比具有相同的根治效果,对机体干扰小,术后康复快,短期疗效方面具有许多优点。腹腔镜手术可作为老年患者结直肠癌根治术的常规术式。     

腹腔镜手术对老年结直肠癌患者安全性及效果的Meta分析

目的 系统评价腹腔镜手术对老年结直肠癌患者的安全性和效果.方法 以“laparoscopic”“laparoscopic colectomy”“colorectal cancer”“rectal cancer”“octogenarian”“elderly”为检索词,检索Pubmed、Web of Sicence和Embase数据库中2000年1月-2017年5月发表的腹腔镜与开腹手术治疗高龄结直肠癌患者的临床研究,提取数据后采用Stata12.0软件对手术指标、术后并发症及远期疗效进行Meta分析.结果 共纳入18项研究,共计3162例患者,Meta分析结果显示,腹腔镜组手术时间长于开腹组(P＜0.001),但术中出血量、术后切口感染、肠梗阻、心血管意外发病率均低于开腹组(均P ＜0.05);两组在淋巴结清扫数目、吻合口瘘、肺炎发病率和总生存率和无瘤生存率方面差异无统计学意义(P＞0.05).结论 腹腔镜手术对高龄结直肠癌患者可取得与开腹手术相同的远期疗效,且术后恢复快,并发症发病率低,安全可靠.     

Efficacy of laparoscopic resection in elderly patients with colorectal cancer

Purpose

The perioperative outcomes of laparoscopic colorectal surgery in elderly patients were compared with those of open surgery in elderly patients and those of laparoscopic surgery in nonelderly patients to evaluate the feasibility and efficacy of laparoscopic surgery in elderly patients with colorectal cancer.

Methods

The data of the patients who underwent surgical resection for colorectal cancer between January 2007 and September 2012 were retrospectively collected. The clinical backgrounds and outcomes of elderly patients (≥70 years of age) who underwent laparoscopic surgery (EL group) were compared with those of elderly patients who underwent open surgery (EO group) and those of nonelderly patients (<70 years of age) who underwent laparoscopic surgery (NL group).

Results

Compared with the EO group, the EL group showed significantly less blood loss (15 versus 100 ml), fewer postoperative complications (10.7 versus 36.7 %), earlier resumption of an oral diet (4 versus 5 days) and shorter postoperative hospital stays (16 versus 28 days). A case-matched analysis showed similar results. All perioperative outcomes were equivalent between the EL and NL groups.

Conclusions

Laparoscopic colorectal surgery in elderly patients with cancer was not only superior to open surgery in elderly patients, but also equivalent to laparoscopic surgery in nonelderly patients in terms of the postoperative outcomes.     

Perioperative host-tumor inflammatory interactions: A potential trigger for disease recurrence following a curative resection for colorectal cancer

The aim of the present review was to investigate whether host-tumor interactions are causal or consecutive clinical factors associated with surgical stress that influence the long-term survival after a curative resection of colorectal cancer. A Medline/PubMed search was conducted to identify the relevant articles investigating the factors related to surgical stress and their effects on the long-term survival after a curative resection of colorectal cancer. The intraoperative state is defined as a cytokine storm in which ongoing local cytokine production occurs at the site of the tumor, thus further enhancing the autocrine cytokine loop for angiogenic factor production. The postoperative state is defined as tissue regeneration in which surgery-related clinical events enhance the systemic induction of inflammatory cytokines, which in turn synergistically exaggerate the local activation of tumor growth factors. Host-tumor interactions under surgical stress may act synergistically as potent tumor growth factors, and may thus influence long-term survival. Controlling surgical insults and/or regulating perioperative inflammatory responses may therefore lead to new therapeutic approaches for controlling disease recurrence.     

Outcome of laparoscopic colectomy for polyps not suitable for endoscopic resection

BACKGROUND: Large colonic polyps or polyps that lie in anatomical locations that are difficult to access at endoscopy may not be suitable for endoscopic resection and therefore may require partial colectomy. This approach eradicates the polyp and allows an oncologic resection should the polyp prove to be malignant. The purpose of this study was to assess outcomes of a laparoscopic approach for the management of these polyps. METHODS: Patients referred for laparoscopic colectomy for colonic polyps were identified from the prospective colorectal laparoscopic surgery database. Demographics, operative details, and final pathology were reviewed. RESULTS: Fifty-one consecutive patients (27 male) with a mean age of 68 +/- 11.4 years, ASA classification (1/2/3/4) of 0/21/27/3, and body mass index (BMI) of 26.5 +/- 4.9 were identified. Right (RHC) and left (LHC) colectomy was performed for 39 right and 12 left colonic polyps. Mean operating time (OT) was 87 +/- 30 min (81 for RHC, 105 for LHC) and mean hospital stay was 3.1 +/- 1.9 days. There were six complications (17.7%), including anastomotic leak (n = 1), small bowel obstruction (n = 2), abscess (n = 1), and exacerbation of preexisting medical conditions (n = 2). Four patients were readmitted (7.8%); one required CT scan-guided abscess drainage (1.9%) and two required reoperation (3.9%). Five patients (9.8%) were converted because of adhesions (n = 3), obesity (n = 1), and inability to identify the area that was tattooed at colonoscopy (n = 1). Mean polyp size was 3.1 cm, and pathology revealed tubular (n = 14), tubulovillous (n = 33) and villous adenoma (n = 2), pseudopolyp (n = 1), and prolapse of the appendix into the cecum mimicking an adenoma (n = 1). High-grade dysplasia was seen in four tubular (33%) and five tubulovillous adenomas (15.5%). Adenocarcinoma not identified at colonoscopy was found in 11 polyps (20%), 9 tubulovillous (27.8%) and both villous adenomas (100%). CONCLUSIONS: Large colonic polyps unresectable at colonoscopy are associated with a high rate of unsuspected cancer. This requires a formal colectomy rather than transcolonic polypectomy. Laparoscopic colectomy offers safe and effective management of these polyps with the benefits of accelerated postoperative recovery.     

腹腔镜与开腹手术治疗65岁以上老年结直肠癌病人的短期结果与预后分析

【摘要】 目的 探讨腹腔镜及开腹手术治疗老年结直肠癌病人的短期结果及预后。方法〓回顾性分析2003年1月至2013年12月广州市第一人民医院胃肠外科收治的行腹腔镜或开腹手术结直肠癌病人的临床、病理资料及随访数据。对两组病人的手术学指标、肿瘤学指标及生存情况进行比较。结果〓从数据库中提取符合上述条件的病人共104例,腔镜手术组63例,开腹手术组41例,腹腔镜组和开腹组病人的基线数据及随访时间差异无统计学意义。腹腔镜组病人术中出血量、首次下床活动时间、首次进食流质时间明显低于开腹组,差异有统计学意义。两组病人总死亡率、肿瘤相关死亡率及复发率差异无统计学意义,生存分析显示两组病人累积总生存率、肿瘤相关生存率及累积无复发率差异无统计学意义。结论〓对于老年结直肠癌病人,腹腔镜手术可以取得优于开腹手术的短期结果及不劣于开腹手术的长期生存结果。     

Outcomes of laparoscopic surgery for colorectal cancer in elderly patients

Objective:

To evaluate the short-term outcomes of laparoscopic colorectal surgery for cancer in the elderly compared with younger patients.

Methods:

We retrospectively considered a consecutive unselected series of 159 patients who underwent elective laparoscopic procedures for colorectal cancer at our institution between January 2007 and December 2009. Of these patients, 101 (63.5%) were ≤70 years of age (Group A), and 58 (36.5%) were >70 (Group B). Operative steps and instrumentation were standardized. Demographics, disease-related, operative, and short-term data were analyzed for each group, and an appropriate statistical comparison was made. Comorbidity was quantified by using the Charlson Comorbidity Index.

Results:

We reviewed right colectomies (29.5%), left colectomies (44.7%), rectal resections (19.5%), and other procedures (6.3%). There was no significant difference in sex ratio, body mass index, American Society of Anesthesiology score, type of surgical procedures, and tumor stage between Group A and Group B. A statistically higher comorbidity according to the Charlson index characterized Group B (2.2 vs 3.8; P=.034). Median operative time (228±78.1min vs 224.3±97.6min; NS), estimated blood loss (50.0±94.8mL vs 31.2±72.7mL; NS), conversion rate (2.0% vs 1.7%; NS), and timing to canalization (4.5±1.7dd vs 4.4±1.3dd; NS) were statistically comparable in both Groups. Group B was associated with a significantly longer length of hospital stay compared with Group A (8.1±2.8dd vs 10.8±6.6dd; P<.01) There was no statistically significant difference in major postoperative complications (3.8% vs 3.4%; NS), reoperations (0.9% vs 1.7%; NS), and 30-day mortality (0% vs 1.7%; NS).

Conclusions:

Laparoscopic colorectal surgery appears feasible and safe in elderly patients with increased comorbidity.     

国内腹腔镜结直肠癌切除术根治效果的Meta分析

目的 评价国内腹腔镜结直肠癌手术的肿瘤根治情况与远期预后.方法 检索2007年10月前国内临床中心以中英文公开发表的结直肠癌腹腔镜与开腹手术根治效果和远期疗效的非随机对照研究(non-randomized comparative studies,NRCs)文献,提取相关指标后综合分析.结果 14篇NRCs资料质量评分为18.92±1.27.腹腔镜与开腹治疗的患者基本特征均衡.结直肠癌腹腔镜手术的肠段切除长度较开腹手术短0.66 cm,远端切缘距肿瘤距离较开腹手术远0.26 cm,2年以上生存率是开腹手术的1.67倍.两种治疗方式的随访率、肿瘤直径大小、淋巴结清扫数目、肿瘤局部复发率和远处转移率差异无统计学意义.结论 NRCs资料的Meta分析认为国内腹腔镜与开腹手术治疗结直肠癌的肿瘤根治情况无差别,但2年以上生存率具有一定优势.     

Outcome of laparoscopic colorectal resection

Background: The aim of this study was to assess the feasibility and safety of laparoscopic surgery for colorectal diseases. Methods: A retrospective review was undertaken of all patients undergoing a laparoscopic colorectal procedure (LCP) for large bowel disease. All opertions were performed by a single experienced team. Patients were divided chronologically into three consecutive groups (G1, G2, and G3). Data collection included the incidence and cause of both proper and mandatory conversions to laparotomy, the incidence and type of early and late postoperative complications, incidence of operative mortality, and the length of hospital stay. The incidences of conversion to laparotomy and of early and late postoperative complications were also determined as related to diagnosis, type of LCP attempted, and chronological group. Results: Between January 1996 and December 2001, a total of 108 patients (49 men and 59 women) with a mean age of 65.1 years underwent an LCP for colorectal disease. Proper conversion to open surgery was necessary in five patients (4.6%), whereas a mandatory conversion was needed in 10 with patients advanced cancer (9.2%). The overall morbidity rate was 11.9%. There were no anastomotic leaks. In two patients (1.85%) developed a complication requiring reoperation. Postoperative mortality was nil. Mean postoperative hospital stay was 7.2 days. The rates of conversion and of early and late complications decreased through the three chronological periods. No trocar site recurrences were observed in the cancer patients. Conclusion: Laparoscopic colorectal surgery performed in experienced centers is safe; the observed morbidity and mortality rates are low and acceptable and compare favorably to those observed after standard open surgery.