대한대장항문학회

Purpose: The aim of this study is to assess the safety and the efficacy of laparoscopic colorectal surgery compared to those of conventional open surgery and to determine the feasibility of laparoscopic colorectal surgery based on oncologic principles. Methods: From March 2001 to January 2002, 27 consecutive patients were assessed for the possible use of laparoscopic surgery. Thirty patients were included in the open group. Forty-seven patients were included in the laparoscopic group. The decision regarding the suitability of a patient for the procedure was made by the surgeon. Results: Laparoscopic surgery was attempted on 47 patients, and in 31 patients, it was completed successfully. Patients who underwent laparoscopic surgery required a smaller dose of analgesics and had an earlier bowel passage recovery and shorter hospital stay than patients who underwent open surgery. The mean operation times for the open group, the conversion group, and the laparoscopic group were 252 min, 269 min, and 272 min respectively (P＞0.05). There was no difference in the number of lymph nodes dissected nor the length of the distal margin of the resected bowel in the case of anterior resection and low anterior resection of the laparoscopic group compared to the open and the conversion groups (P＞0.05). Complications in the laparoscopic surgery group were anastomosis site leakage and bowel obstruction. In the open group, wound infection, urinary retention, anastomosis site leakage and bowel obstruction were found. The morbidities of the open group, the conversion group, and the laparoscopic group were 23.3%, 37.5%, and 12.9%, respectively. One mortality was observed in the conversion group. Conclusions: In this study, there is no evidence that the laparoscopic technique is inadequate for following the cancer surgery principle, So laparoscopic colorectal surgery is a safe and feasible treatment. The overall morbidity and mortality in this study were acceptable. Sufficient lymph node dissection and distal margin of the resected bowel were accomplished with laparoscopic surgery. Further long-term follow up, however, will be necessary to confirm the value of this technique. J Korean Soc Coloproctol 2004;20:8-14