| Abstract: | Abstract: The intraoperative and postoperative complications of laparoscopic colectomy were analyzed in a consecutive series of 69 cases in our experience. The final histological diagnosis of these patients was adenoma of the colon in eight, carcinoma of the colon and rectum in 59, leiomyoma of the colon in one and Crohn's disease in one. The TIMM staging of the carcinomas in our series was Tis in four, T1 in 20, T2 in 10 and T3 in 25 cases. Conversion to open surgery was necessary in four of the 69 cases. The reasons for conversion were bleeding in two, adhesion in one and malignant invasion to the bladder in one. Major postoperative complications occurred in the four cases in whom a reoperation was carried out. These included perforation of the colon, pancreatic fistula, ileus and bleeding. Among the 11 minor postoperative complications, wound infection was the most frequent and occurred in six cases. There were no operative or postoperative deaths. The postoperative observation period ranged from one month to 41/2 years. There was only one case with a possible local recurrence who had a CEA level of 34 ng/ml. In this patient, no findings of port site recurrence were detected. We thus consider laparoscopic-assisted colectomy, when done by technically well experienced surgeons, to be an effective and curative procedure for the treatment of colorectal carcinoma. However, in view of our complication rate, both sufficient training and experience with the techniques required to perform a laparoscopic colectomy are important for the future development of this procedure. |
