Laparoscopic-assisted colorectal surgery. Lessons learned from 240 consecutive patients.
OBJECTIVE
To audit the development and outcomes of laparoscopic colorectal surgery at the Royal Brisbane Hospital.


METHODS
Since July 1991, laparoscopic-assisted colectomy for benign and malignant colorectal disease has been performed on more than 300 patients at the Royal Brisbane Hospital. This paper summarizes the outcome for the first 240 patients who underwent a laparoscopic colorectal procedure. All laparoscopic data were collected prospectively, and for selected studies, data were compared with open surgical controls.


RESULTS
Nineteen patients required open conversion (7.9 percent). There was a significant decrease in wound infection rates in patients having a laparoscopic-assisted colectomy (3.6 percent) compared with historical controls (7.9 percent) (P < 0.05; chi-squared). There were five anastomotic leaks, five laparotomies for postoperative adhesive obstruction, and four perioperative deaths. A total of 103 patients had a procedure for colorectal cancer. Of the 79 potentially curative procedures, there have been 5 (6.3 percent) recurrences to date.


CONCLUSIONS
The overall morbidity and mortality in this series seem to be acceptable compared with that of open procedures.
Lumley
J W
JW
Department of Surgery, Royal Brisbane Hospital, Herston, Australia.
Fielding
G A
GA
Rhodes
M
M
Nathanson
L K
LK
Siu
S
S
Stitz
R W
RW
D003108:Colonic Diseases / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D011183:Postoperative Complications; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D012008:Recurrence; D016896:Treatment Outcome