Abstract
A multicenter retrospective study was undertaken to assess the efficacy and safety of laparoscopy in colon and rectal surgery. To minimize potential bias in interpretation of the results, all data were registered with an independent observer, who did not participate in any of the surgical procedures. Sixty-six patients underwent a laparoscopic procedure. Operations performed included sigmoid colectomy (19), right hemicolectomy (15), low anterior resection (6), colectomy with ileal pouch-anal anastomosis (IPAA) (5), and abdominoperineal resection (APR) (3). The conversion rate from laparoscopic colectomy to celiotomy was 41 percent. Major morbidity and mortality were 24 percent and 0 percent, respectively. Length of stay, hospital costs, and lymph node harvest were compared between the sigmoid resection and right hemicolectomy subgroups. Data from traditional sigmoid colectomies and right hemicolectomies were obtained from the same institutions for comparison. Mean postoperative stay for laparoscopically completed sigmoid and right colectomies was significantly less than that for either the converted or the traditional groups (P <0.02). Total hospital cost for traditional right hemicolectomy was significantly less than that for the converted group (P < 0.05) but not the laparoscopic group. Laparoscopic sigmoid resection showed no significant total hospital cost difference among traditional, converted, and laparoscopic groups. Lymph node harvest in resections for carcinoma was comparable in all groups. These preliminary data suggest that laparoscopic colon and rectal surgery can be accomplished with acceptable morbidity and mortality when performed by trained surgeons. Length of stay is shorter, but there is no proven total hospital cost benefit. Appropriate registries will be necessary to adequately assess long-term outcome.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Berci G, Sackier JM. The Los Angeles experience with laparoscopic cholecystectomy. Am J Surg 1991;161:382–4.
Cuschieri A, Dubois F, Mouiel J,et al. The European experience with laparoscopic cholecystectomy. Am J Surg 1991;161:385–7.
Flowers JL, Bailey RW, Scovill WA, Zucker KA. The Baltimore experience with laparoscopic management of acute cholecystitis. Am J Surg 1991;161:388–92.
Arregui ME, Davis CJ, Arkush A, Nagan RF. In selected patients outpatient laparoscopic cholecystectomy is safe and significantly reduces hospitalization charges. Surg Laparosc Endosc 1991;1:240–5.
Peters JH, Ellison EC, Innes JT,et al. Safety and efficacy of laparosocpic cholecystectomy. Ann Surg 1991;213:3–12.
Wexner SD, Johansen OB. Laparoscopic bowel resection: advantages and limitations. Ann Med 1992;24:105–10.
Nogueras JJ, Wexner SD. Laparoscopic colorectal surgery. Perspect Colon Rectal Surg 1992 (in press).
Wexner SD, Johansen OB, Nogueras JJ, Jagelman DG. Laparoscopic total abdominal colectomy: a prospective trial. Dis Colon Rectum 1991;35:651–5.
Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surgical Laparosc Endosc 1991;1:144–50.
Blenkinsopp WK, Stewart-Brown S, Blesovsky L,et al. Histopathology reporting in large bowel cancer. J Clin Pathol 1981;34:509–13.
Scott KW, Grace RH. Detection of lymph node metastases in colorectal carcinoma before and after fat clearance. Br J Surg 1989;76:1165–7.
Author information
Authors and Affiliations
Additional information
Read at the meeting of The American Society of Colon and Rectal Surgeons, San Francisco, California, June 7 to 12, 1992. Winner of the William C. Bernstein, M.D. Award of the Midwest Society of Colon and Rectal Surgeons.
About this article
Cite this article
Falk, P.M., Beart, R.W., Wexner, S.D. et al. Laparoscopic colectomy: A critical appraisal. Dis Colon Rectum 36, 28–34 (1993). https://doi.org/10.1007/BF02050298
Issue Date:
DOI: https://doi.org/10.1007/BF02050298