Indications for and Results of Laparoscopic Minimally Invasive Surgery for Colorectal Carcinoma

Nobuyoshi Miyajima, Tatsuo Yamakawa

Department of Surgery, Teikyo University Hospital, Mizonokuchi

Laparoscopic surgery for colorectal carcinoma has been employed in many institutes in our country. However, the indications and techniques are not standardized yet. The aim of this study was to determine the indications and limitation of laparoscopic surgery for colorectal carcinoma. Laparoscopic colorectal surgery has been performed on 105 patients in our department. Eighty-one cases of them (77.1%) had been malignant tumors. The location of the tumor was the cecum in 5 cases, ascending colon in 5, transverse colon in 10, descending colon in 4, sigmoid colon in 39 nd rectum in 18. The root of the inferior mesenteric artery can esily be dissected intracorporeally in cases of left side colorectal carcinoma, but intracorporeal dissection of the root of the middle colic artery was not indicated in the first 3 cases and it was dissected extracorporeally with 5 cm laparotomy. No statistical difference was noted in the number of lymph nodes resected by laparoscopic surgery and conventional surgery. Recovery after the operation was faster in the laparoscopic surgery group than in the conventional surgery group. Perioperative complications were seen in 2 cases, but they improved with conservative therapy. The cancer recurred in 1 case 1 year after the operation. Port site recurrence has not been encountered in any cases. We believe that systematic lymph adenectomy can be performed in laparoscopic surgery if the lesions are not located in the lower rectum.

Key words
laparoscopic surgery, colorectal carcinoma, minimally invasive surgery

Reprint requests
Nobuyoshi Miyajima Department of Surgery, Teikyo University Hospital, Mizonokuchi
3-8-3, Mizonokuchi Takatsu-ku, Kawasaki, 213-8507 JAPAN

Accepted
December 3, 1997

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