Clinical Survey Of Laparoscopic Colorectal Carcinoma Surgery

Objective This survey was aimed to evaluate the advantages and disadvantages of laparoscopic surgery in colorectal cancer.Methods Clinical records of 22 cases of laparoscopic colorectal operation from Janualy 2002 to October 2006 were reviewed and compared with those of 40 comparable cases treated by conventional open surgery in the same period under the following parameters:surgical guidelines,postoperative recovery guidelines,tumor radical resection guidelines,operation fee and hospitalization fee,overall morbidity rate,and postoperative outcome.Results In laparoscopic group,2 cases(8.3%)were converted to open surgery.Intraoperative blood loss,bowel function restoration time,urinary catheter removal time,out-of-bed activity time and postoperative anodyne consumption were(238.86±109.33)ml,(2.69±0.87)days,(3.16±2.54)days, (3.24±0.80)days,(0.5±1.0)times per capital respectively.While those in open surgery group were(372.00±218.03)ml,(4.05±2.08)days,(5.58±5.08)days, (7.09±1.20)days,(1.5±1.0)times per capital respectively,which were significantly higher than those in laparoscopic group(P＜0.05)But in the laparoscopic group longer mean operation time[(365.82±119.60)min vs(224.55±56.90)min,P＜0.05]and higher operation costs[(1.06±0.27)thousand RMB vs(0.65±0.13)thousand RMB,P＜0.05]and hospitalization costs [(3.78±0.90)thousand RMB vs(3.15±0.99)thousand RMB,P＜0.05]were observed.No significant differences were detected between two groups in tumor size[(4.95±1.97)cm vs(5.61±2.01)cm,P＞0.05],colon specimen length [(25.00±8.39)cm vs(23.15±6.9)cm,P＞0.05],rectum specimen length [(16.10±5.00)cm vs(18.58±5.71)cm,P＞0.05],distal margin[(2.63±1.13)cm vs(3.10±1.23)cm,P＞0.05]and lymph node harvest[4.05±3.74 vs 2.70±2.47, P＞0.05].The overall morbidity rates were 9.1%and 32.5%(P＜0.05),with a statistical significance.There were no significant differences between two groups in local recurrence(4.5%vs 5.0%,P＞0.05),distant metastasis rate (13.6%vs12.5%,P＞0.05)and mortality after operation(9.1%vs15.0%,P＞0.05).Conclusions Laparoscopic surgery has the same effect as traditional radical operation in colorectal cancer patients,and it is a safe and feasible technique with less surgical trauma and quicker recovery But with longer mean operation time and higher medical expenses.