Current attitudes in laparoscopic colorectal surgery.
BACKGROUND
In this study, we set out to examine the current attitudes among surgeons toward laparoscopic colorectal surgery (LCS).


METHODS
A total of 3628 questionnaires were sent to all North American members of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES) and the American Society of Colon and Rectal Surgeons (ASCRS); 40% of the members of each society responded (B15 respondents).


RESULTS
Currently, 85% of the respondents perform laparoscopic surgery; LCS was performed by 48% of the respondents in 21% of their patients. Although 35% of the members of SAGES have increased the number of laparoscopic colorectal operations they perform in the last 3 years, only 26% of ASCRS members did so. Our findings showed that 74% of the surgeons who perform LCS do so for diverticular disease, 68% for colonic polyps, 61% for villous adenoma, and 36% for ileal Crohn's disease. However, only 15% operate for the cure of carcinoma of any stage (16% of SAGES members and 11% of ASCRS members), whereas 8.5% and 7% operate for the cure of all upper and lower rectal carcinomas, respectively. Thirty-six percent of the surgeons who perform LCS for cancer have done between one and 10 curative resections, 8% have done 11-20 procedures, and 14% have done >20 procedures. There were 80 cases of port site recurrence reported by 4.4% of surgeons. Although 56% of the respondents would themselves undergo laparoscopic colorectal surgery for a rectal villous adenoma, only 9% would do so for a distal-third rectal carcinoma (12% of SAGES and 5% of ASCRS respondents).


CONCLUSIONS
The overall percentage of respondents performing LCS has decreased over the last 3 years; moreover, surgeons are more hesitant to perform laparoscopic surgery for the cure of colonic cancer. Due to the overall low response rate, the fact that 4.4% of those surgeons who did respond have seen port site recurrences does not allow any conclusions to be drawn about the prevalence of this problem.
Mavrantonis
C
C
Department of Colorectal Surgery, Cleveland Clinic Florida, 3000 West Cypress Creek Road, Fort Lauderdale, FL 33309, USA.
Wexner
S D
SD
Nogueras
J J
JJ
Weiss
E G
EG
Potenti
F
F
Pikarsky
A J
AJ
D000236:Adenoma / Q000601:surgery; D001291:Attitude of Health Personnel; D002277:Carcinoma / Q000601:surgery; D003082:Colectomy / Q000706:statistics & numerical data; D003108:Colonic Diseases / Q000175:diagnosis / Q000601:surgery*; D003111:Colonic Polyps / Q000601:surgery; D003107:Colorectal Surgery / Q000706:statistics & numerical data*; D003625:Data Collection; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D009367:Neoplasm Staging; D009656:North America / Q000453:epidemiology; D011159:Population Surveillance; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery*; D012955:Societies, Medical / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires