대한대장항문학회

Purpose : To evaluate the possibility that laparoscopic procedure could perform surgeries<br>keeping the principle of oncologic surgery. Methods : From July 1993 to June 1996, thrity<br>patients undergone laparoscopic assisted colon and rectal resections (LR) for malignant<br>disease at Yeungman university hospital. Margins of resection and lymph nodes (LNs)<br>recovered were compared with those of thirty stage matched open resection cases (OR, n=30)<br>retrospectively. There was no operative mortality in both group. Operative techniques used in<br>LR vs OR were colectomy, 5：6; anterior resection, 6：5; low anterior resection, 11：12 and<br>abdominoperineal resection, 8：7. Parameters were analgesic use, duration of postoperative<br>ileus, operative time, hospital stay, margins of rescetion, lymph node yield (LNs), and<br>recurrence. Results : Patients who underwent LR had less pain, a shorter period of<br>postoperative ileus and hospital stay than patients who underwent OR. But, the length of<br>operative time was greater for patients undergoing LR. Mean lymph node yield in the<br>laparoscopic group was 16 compared with 18.1 in the open group (P=0.560). Average margins<br>of resection in LR vs OR were 13.9 cm vs 14.1 cm proximally (P=0.823), 3.6 cm vs 5.2 cm<br>distally (P=0.498). In no case did the margins contain tumor. There was no statistical<br>significance in dissected LNs and the length of both resection margins in both groups.<br>Recurrence was similar in both groups. Conclusions : In this study, there is no evidence that<br>laparoscopic technique is inadequate in following the cancer surgery principle.<br>