LAPAROSCOPIC APPROACH IN COLO-RECTAL SURGERY FOR CANCER: IS IT
LAWFULL ?
C. Gouillat
Département de chirurgie, Hotel Dieu, C.H.U. Lyon, France
Jurnalul de chirurgie 2005; 1 (2):165-171
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Abstract
Many surgeons were performing laparoscopic approach for colo-rectal
surgery from at least 10 years. Even some reported results were „excellent”,
there are discussions about this subject. I performed a review of
the literature; I found 11 randomised studies wich compared laparoscopic
vs. open colectomies.
Fesability of laparoscopic technique was established by a randomised
multi-center study: operation time was increased with about one hour
(vs. open surgery) and conversion rate was 15 - 16%. The technique
is difficult and conversion rate decreased with experience of the
surgeon. Postoperative course was better in laparoscopic surgery (from
point of view of postoperative pain, postoperative ileus, respiratory
complications, hospital stay and quality of life).
Laparoscopic colo-rectal surgery is more expensive that open technique.
In all this papers, I didn’t find significant “oncologic”
difference between laparoscopic and open colo-rectal resections.
Conclusions: laparoscopic colectomies are safe for experienced
surgeons; laparoscopic technique is indicated in selection cases.
KEYWORD: LAPAROSCOPIC COLECTOMY, FESABILITY, COLO-RECTAL SURGERY,
QUALITY OF LIFE
Correspondence: Prof. Dr. Christian Gouillat, Département
de chirurgie, Hotel Dieu, 1 place de l’Hôpital, 69288
LYON CEDEX 02, C.H.U. Lyon, France, e-mail: christian.gouillat@chu-lyon.fr
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