OUR PRELIMINARY EXPERIENCE WITH LAPAROSCOPIC TREATMENT OF RECTAL CANCER

Summary Evidence from randomised controlled trials has shown that laparoscopic colon and rectal cancer resection not only confers short-term benefits but also does not differ considerably in terms of its long-term oncological outcomes, as compared with open surgery. The aim of this article was to present our preliminary experience with laparoscopic resections for rectal cancer. All laparoscopic started resections of the rectum performed between January 2008 and December 2010 in First Clinic of Surgery, University Hospital St. Marina were included in our study. Over this period, 29 patients (9 male), median age 65 years (range 24 to 88), underwent laparoscopic resection of the rectum.The majority of the procedures were performed for malignant disease (86.3 %) and the most common procedure was anterior resection with TME (Total Mesorectal Excision) – in 79.4% of cases. The median duration of surgery was 135 minutes (range 65 to 330), with conversions to open surgery in 3 patients (12.5%). Complications occurred in 5 patients (18%), including anastomotic leaks in 1 (4 percent). The median length of hospital stay was five days (range 3 to 90) and the median follow-up was 19 months (range 1 to 46). The principles of good open surgery are relevant to laparoscopy, but the subtleties of pelvic surgery, however, may not make rectal cancer entirely ideal for laparoscopy. To establish the equivalency of the laparoscopic approach, all laparoscopic rectal resections should be completed in an environment wherein outcomes can be meaningfully evaluated and the clinical relevance of laparoscopic resection can be determined.Key words: laparoscopic resection, rectal carcinoma, short term results, long term results, oncological safety