LAPAROSCOPIC ASSISTED SURGERY IN COLORECTAL CANCER: OUR EXPERIENCE

BACKGROUND Laparoscopically assisted surgery was first conducted in 1990 for a patient undergoing colectomy for cancer. A recent increase in the number of reports, retrospective analyses, and trials has now provided sufficient data to support the role of laparoscopy in colorectal cancer surgery. We, here by present our initial experience regarding the feasibility, safety, short-term outcomes following laparoscopic surgery for colorectal cancers. MATERIALS AND METHODS It is a retrospective descriptive study. From January 2013 to Dec 2015, 30 patients with primary rectal cancer underwent laparoscopic assisted surgery at our institution (Kidwai Memorial Institute of Oncology). Patients with rectal cancer recurrences, emergency cases, and rectal cancer treated by conventional methods, fixed rectal cancer and metastatic rectal cancer were excluded from the study. Descriptive variables like age and gender, whereas outcome variables like type of resection, number of resected lymph nodes, proximal, distal and circumferential margin, need for ostomy, complications, operating time and hospital stay are noted and analysed. RESULTS This preliminary data suggests that rectal cancer resection can be performed by laparoscopy in accordance with established principles of cancer therapy. Operative time was 190 -240 minutes, reduced postoperative morbidity rate. The mean length of hospital stay was 10 days (post-operative stay-3-5 days) and hence shorter post-operative hospital stay and briefer use of parenteral narcotics and oral analgesics are also noted. In the laparoscopic surgery, average yield was 16 lymph nodes, adequate lymphadenectomy was achieved in 70% of cases. There is slight increase in hospital costs. CONCLUSION Laparoscopic approach is an acceptable alternative to open surgery for colon rectal cancer in select cases. It is also as safe and effective as laparotomy in the treatment of colorectal cancer, and was associated with increased operative time, shorter hospital stay, less morbidity improved quality of life, and slightly increased hospital costs.