Minimally Invasive Surgery for Early Colorectal Cancer

Masahiko Watanabe, Masahiro Ohgami, Tatsuo Teramoto, Masaki Kitajima

Department of Surgery, School of Medicine, Keio University

Minimally invasive surgery has been extensively performed in our department for early colorectal cancer. Among patients with colonic cancer limited to the mucosa (m cancer) which could not be removed endoscopically, five underwent intracorporeal laparoscopic resection, while extracorporeal laparoscopic-assisted resection was performed in 10. Thirty-four patients with m cancer underwent perianal local resection. Postopertive pain was very mild, and these patients could be discharged within a week after surgery. In addition, the laparoscopically retrieved specimen could be examined pathologically in detail. Among 100 patients with cancer limited to the submucosa (sm cancer), 1.7% (l/56) of the patients with colon sm cancer and 9.1% (4/44) of the patients with rectal sm cancer had positive lymph node (LN) metastases, all of which were in the paracolic LNs adjacent to the tumor. Therefore, patients with sm cancer with vessel invasion or poorly differentiated adenocarcinoma should undergo partial resection of the colon with lymphdenectomy. The indications for minimally invasive surgery can be extended to patients not only with m cancer but also those with sm cancer.

Key words
minimally invasive surgery, early colo-rectal cancer, laparoscopic surgery

Reprint requests
Masahiko Watanabe Department of Surgery, School of Medicine, Keio University
35 Shinanomachi, Shinjuku-ku, Tokyo, 160 JAPAN

Accepted
June 14, 1993

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