title: Palliative laparoscopic resections for Stage IV colorectal cancer.
abstract: OBJECTIVE
  Issues surrounding the safety and efficacy of palliative laparoscopic resections for patients with Stage IV colorectal cancer have not been explicitly examined in the literature. This article describes our experience with laparoscopic procedures for patients with Stage IV colorectal cancer and compares their perioperative outcomes to a contemporaneous group of patients with clinically curable (Stages I-III) disease.
  
  
  METHODS
  A prospective database of laparoscopic resections for colorectal cancer performed between 1991 and 2002 was reviewed. Data regarding patient demographics, perioperative morbidity and mortality, operative times, conversion rates, and length of stay were extracted. Statistical analysis included chi-squared and Student's t-tests as required and P<or=0.05 was considered significant.
  
  
  RESULTS
  A total of 375 cases were identified, of these 49 (13 percent) underwent laparoscopic palliative resections while 326 (87 percent) patients had resections for cure. When comparing palliative to curative procedures, there were no differences in intraoperative (4 percent vs. 9 percent) or postoperative complications (14 percent vs. 12 percent), perioperative mortality (8 percent vs. 4 percent), or length of hospital stay. Patients with Stage IV disease had larger tumors (5.4+/-2.3 cm vs. 4.6+/-2.6 cm, P=0.04) which contributed to an increased rate of conversion (22 percent vs. 11 percent, P=0.05) with most conversions secondary to tumor fixation or bulk (64 percent) preventing determination of resectability.
  
  
  CONCLUSIONS
  A palliative laparoscopic resection is a safe and feasible option and presents acceptable morbidity and mortality in patients with Stage IV colorectal cancer. Importantly, in this difficult group of patients, our results compare favorably with those from previously published series of open procedures.
authors.affiliation: St. Michael's Hospital, Toronto, Ontario, and Le Centre Hospitalier Universitaire de Québec, Université Laval, Canada.
authors.forename: Husein
authors.initials: H
authors.lastname: Moloo
authors.forename: Eric L R
authors.initials: EL
authors.lastname: Bédard
authors.forename: Eric C
authors.initials: EC
authors.lastname: Poulin
authors.forename: Joseph
authors.initials: J
authors.lastname: Mamazza
authors.forename: Roger
authors.initials: R
authors.lastname: Grégoire
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Schlachta
mesh_terms: D000368:Aged; D003082:Colectomy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010166:Palliative Care; D012189:Retrospective Studies; D016896:Treatment Outcome