Reflection of surgical oncology in laparoscopic colorectal surgery. Single centre experiences of 259 consecutive cases: P060

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Aim:Prospective database of 309 LAP colorectal resections between 2004 and 2009 ispresented. During this period 1202 open resections occurred. Exclusion criteria for LAP interventions: abdominal wall infiltration,previous surgery at operation field.Method:Patients were matched in pairs for the following criteria: sex, age, ASA score, tumour location, stage, and type of resection. Two hundred and fifty-nine patients undergoing laparoscopy for malignant tumour were compared with patients treated by laparotomy during the same period. Openprocedures were done by surgeons trained in laparoscopy except three who performed nonlaparoscopic surgery. Right, left hemicolectomy, sigmoid, rectum resections and were performed. Operative, postoperative, and oncologic outcomes were compared.Results:Operative time was similar in right hemicolectomy groups, higher in all other LAP interventions. Conversion rate was 10.6%. General morbidity was similar in the LAP and open groups (12.5% vs 14.7%) Postoperative hospital stay was significantly shorter for LAP patients (5.7 vs 9.6 days; P < 0.0001). Surgical margin, length of resected specimen and number of lymph nodes were not affected by laparoscopy in hemicolectomy and sigmoid groups. In 120 LAP rectum cases five abdomino-perineal excisions (4.16%) occured. Length of resected rectum (24 ± 8 vs 15 ± 7 cm), number of lymph nodes (13 ± 4 vs 8 ± 5) were significantly higher in LAP group.Conclusion:Laparoscopic resection gave a better post-operative outcome and a possible more favourable oncologic consequences, especially in rectum carcinomas.

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