Improving Result of Laparoscopic Colorectal Surgeries in a Training Hospital

Background. Several large randomized control trials on colorectal cancer have shown compatible short-term and long-term oncological outcomes between laparoscopic and open surgery. However, the process of incorporating such practice in a major medical center in Taiwan has not been explored. We described our 2-year experience of developing laparoscopic colorectal surgery at our training hospital.Methods. From July 2007 to December 2009, total 432 patients underwent laparoscopic colorectal surgery in Taipei Veterans General Hospital. We compared the outcomes during two 6-month periods: July 2007 to December 2007 (initial phase) and July 2009 to December 2009 (later phase).Results. After gaining experience, the surgeons were able to perform laparoscopic colorectal surgeries in more patients with a history of abdominal surgery, and the rate of conversion to open surgeries significantly decreased (p = 0.03). In addition, the operative time for laparoscopic right hemicolectomy and anterior resection significantly reduced in the later phase (p = 0.01). An increase in the number of harvested lymph nodes was observed (p ＜ 0.01). No significant differences were observed in the postoperative morbidity, mortality, and duration of hospital stay for the 2 phases.Conclusion. Laparoscopic colorectal surgeries could become a standardized procedure in a major training hospital in Taiwan without increasing morbidity and mortality.