Safety and feasibility of laparoscopic colo-rectal surgery for cancer at a tertiary center in a developing country: Egypt as an example.
BACKGROUND
Laparoscopic colectomy has been shown to have significant short- and long-term benefits compared to open approach. The incorporation of laparoscopy in developing countries is challenging, due to the high costs of equipment and lack of expertise. The aim of this study was to evaluate the safety and feasibility of laparoscopic colorectal surgery for cancer that could be performed in developing countries under different circumstances in developed countries.


METHODS
Thirty-seven patients (23 males and 14 females) with colorectal cancer with a median age of 46 years (39-72) have been enrolled for laparoscopic colo-rectal surgery in a tertiary center in Egypt (South Egypt Cancer Institute) with the trend of reuse of some disposable laparoscopic instruments.


RESULTS
The median operative time was 130 min (95-195 min). The median estimated blood loss was 70 ml (30-90 ml). No major intra-operative complications have been encountered. Two cases (5.5%) have been converted because of local advancement (one case) and bleeding with unavailability of vessel sealing device at that time (one case). The median time for passing flatus after surgery was 36 h (12-72 h). The median hospital stay was 4.8 days (4-7 days). The peri-operative period passed without events. Pathologic outcome revealed that the median number of retrieved lymph nodes was 14 (range 9-23 lymph node) and all cases had free surgical margin.


CONCLUSIONS
Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.
Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Egypt. Electronic address: anwar71@oita-u.ac.jp.
Anwar Tawfik
AT
Amin
Department of Surgical Oncology, South Egypt Cancer Institute, Assiut University, Egypt.
Badawy M
BM
Ahmed
Department of Medical Oncology, South Egypt Cancer Institute, Assiut University, Egypt.
Salah Mabrouk
SM
Khallaf
D000328:Adult; D000368:Aged; D003082:Colectomy; D015179:Colorectal Neoplasms / Q000601:surgery*; D003906:Developing Countries; D004534:Egypt; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D062606:Tertiary Care Centers
Colorectal surgery; Laparoscopic colectomy; Laparoscopy