Laparoskopická kolorektální chirurgie pro karcinom – zhodnocení vlastního souboru

Laparoscopic Colorectal Surgery for Carcinomas – Assessment of the Authors‘ Patient Group

Aim of the work:
The aim was to assess short-term and long-term results of miniinvasive procedures for colorectal carcinomas.

Methods:
This prospective study assessed patients indicated for laparoscopic procedures for their large intestinal or rectal carcinomas from 1993 to 2004. Primarily, their peroperative complications, postoperative course and long-term results were assessed. The Kaplan-Meier analysis was used to assess long-term survival rates.

Results:
Over the 11-year period, a total number of 399 patients (236 males and 163 females) were laparoscopically operated for colorectal carcinomas. In 284 patients, the tumor was located in the colon region and in 115 patients in the rectal region. The stage B and C (Dukes classification), medium to highly differenciated, tumors prevailed. Resection of the sigmoid, right-sided hemicolectomy, low anterior resection of the rectum and amputation of the rectum were the most frequently conducted procedures. 311 procedures (78%) were curative, 88 were paliative (22%). Peroperative complications occured in16 patients (4%), reoperations were required in 34 patients (8.5%). The recovery time for peristalsis was on the second postoperative day, on average. Food load was, on average, tolerated since the third postoperative day and the first stool appeared, on average, on the fourth postoperative day. Early mortality rate reached 6.5%. Postoperative hospitalization lasted, on average, 12 days. In our patient group, a five-year survival rate without relapses was 80% in the carcinoma patients and 68% in the rectal carcinoma patients.

Conclusion:
Laparoscopic colorectal surgery is a safe method with a number of pros for a patient as well as a surgeon in a comparable oncological radicality as that of the open method.

Key words:
laparoscopy – colorectal surgery – laparoscopic surgery