Laparoscopic Resection for Colorectal Neoplasms (Report of 18 Cases )_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HUANG Shichuan , YOU Zhijian , LIANG Zijun , WANG Zaiguo , YU Wusheng , HE Runpei , LAI Guowei

Department of Oncologic Surgery, People’s Hospital of Dongguan City, Guangdong Province, Dongguan 523018, ChinaCorresponding Author: HUANG Shi-chuan, E-mail: hsc1013@163.com;

Corresponding author：

Keywords：

Colorectal neoplasm; Laparoscope; Operation

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Objective 　To explore the safety, effectiveness, operation mode and clinical value of the laparoscopic colorectal resection.
Methods 　The clinical data and experiences of laparoscopic resection for 18 cases with colorectal neoplasm from Jun. 2007 to Mar. 2008 were studied retrospectively.
Results 　Among 18 cases, there were 5 cases of rectal cancer, 6 cases of sigmoid colon carcinoma, 2 cases of sigmoid colonic polyp, 2 cases of descending colon carcinoma, 2 cases of ascending colon carcinoma and 1 case of ascending colonic lipoma. Fifteen cases of laparoscopic colorectal resection were performed successfully, including Dixon procedure 4 cases, Miles operation 1 case, radical resection of sigmoid colon 5 cases, palliative resection of sigmoid colon 2 cases, left hemicolectomy 2 cases and right hemicolectomy 1 case. Three cases converted to laparotomy due to adiposity or advanced status of local disease. Average intraoperative blood loss was 110 ml. The average number of lymph nodes dissected was 13.5. It took about 40 hours to restore intestinal function. The average time of hospitalization was 9 days. No one died during operation and no complications such as anastomotic leakage and postoperative hemorrhage occurred.
Conclusion 　Laparoscopic resection for colorectal neoplasms possesses less trauma and rapid postoperative recovery. Laparoscopic colorectal surgery is safe and effective with skill and indication.

Citation： HUANG Shichuan,YOU Zhijian,LIANG Zijun,WANG Zaiguo,YU Wusheng,HE Runpei,LAI Guowei. Laparoscopic Resection for Colorectal Neoplasms (Report of 18 Cases ). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2008, 15(10): 722-725. doi: Copy

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7.	Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [Ｊ]. Dis Colon Rectum, 2005; 48(12)∶2217.
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11.	陶凯雄, 王国斌, 张波, 等. 腹腔镜辅助下全结直肠切除术治疗结直肠多发性疾病 [Ｊ]. 腹腔镜外科杂志, 2006; 11(4)∶274.
12.	Tseng LN, Berends FJ, Wittich P, et al. Port-site metastases. Impact of local tissue trauma and gas leakage [Ｊ]. Surg Endosc, 1998; 12(12)∶1377.
13.	郑民华. 腹腔镜大肠癌切除术后复发转移的原因及预防 [Ｊ]. 中华外科杂志, 2002; 22(6)∶331.
14.	Patankar SK, Larach SW, Ferrara A, et al. Prospective comparison of laparoscopic vs. open resections for colorectal adenocarcinoma over a ten-year period [Ｊ]. Dis Colon Rectum, 2003; 46(5)∶601.
15.	Gutt CN, Kim ZG, Schmandra T, et al. Carbon dioxide pneumoperitoneum is associated with increased liver metastases in a rat model [Ｊ]. Surgery, 2000; 127(5)∶566.
16.	Schneider C, Jung A, Reymond MA, et al. Efficacy of surgical measures in preventing port-site recurrences in a porcine model [Ｊ]. Surg Endosc, 2001; 15(2)∶121.
17.	Zmora O, Gervaz P, Wexner SD. Trocar site recurrence in laparoscopic surgery for colorectal cancer [Ｊ]. Surg Endosc, 2001; 15(8)∶788.
18.	Gervaz P, Pikarsky A, Utech M, et al. Converted laparoscopic colorectal surgery [Ｊ]. Surg Endosc, 2001; 15(8)∶827.
19.	赵国良, 张英豪, 薄涛. 心功能Ⅱ级患者行低气腹压腹腔镜胆囊切除术18例临床分析 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(6)∶568.
20.	于永扬, 杨烈, 周总光, 等. 腹腔镜全直肠系膜切除保肛术后生活质量评估 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(5)∶524.

1. 6　Franklin ME, Kazantsev GB, Abrego D, et al. Laparoscopic surgery for stage Ⅲ colon cancer: long-term follow-up [Ｊ]. Surg Endosc, 2000; 14(7)∶612 7　Moore JW, Bokey EL, Newland RC, et al. Lymphovascular clearance in laparoscopically assisted right hemicolectomy is similar to open surgery [Ｊ]. Aust N Z J Surg, 1996; 66(9)∶605.
2. 　The Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer [Ｊ]. N Engl J Med, 2004; 350(20)∶2050.
3. 　Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy) [Ｊ]. Surg Laparosc Endosc, 1991; 1(3)∶144.
4. 　黎前德, 杨培, 王东, 等. 13 840例腹腔镜手术临床分析 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(6)∶554.
5. 　Vignali A, Braga M, Zuliani W, et al. Laparoscopic colorectal surgery modifies risk factors for postoperative morbidity [Ｊ]. Dis Colon Rectum, 2004; 47(10)∶1686.
6. 　郑民华, 马君俊. 腹腔镜外科在争议中发展 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(5)∶503.
7. 　Braga M, Frasson M, Vignali A, et al. Laparoscopic vs. open colectomy in cancer patients: long-term complications, quality of life, and survival [Ｊ]. Dis Colon Rectum, 2005; 48(12)∶2217.
8. 　Lacy AM, García-Valdecasas JC, Delgado S, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial [Ｊ]. Lancet, 2002; 359(9325)∶2224.
9. 　Guillou PJ, Quirke P, Thorpe H, et al. MRC CLASICC trial group. Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial [Ｊ]. Lancet, 2005; 365(9472)∶1718.
10. 　Campos FG. Complications and conversions in laparoscopic co-lorectal surgery: results of a multicenter Brazilian trial [Ｊ]. Surg Laparosc Endosc Percutan Tech, 2003; 13(3)∶173.
11. 　陶凯雄, 王国斌, 张波, 等. 腹腔镜辅助下全结直肠切除术治疗结直肠多发性疾病 [Ｊ]. 腹腔镜外科杂志, 2006; 11(4)∶274.
12. 　Tseng LN, Berends FJ, Wittich P, et al. Port-site metastases. Impact of local tissue trauma and gas leakage [Ｊ]. Surg Endosc, 1998; 12(12)∶1377.
13. 　郑民华. 腹腔镜大肠癌切除术后复发转移的原因及预防 [Ｊ]. 中华外科杂志, 2002; 22(6)∶331.
14. 　Patankar SK, Larach SW, Ferrara A, et al. Prospective comparison of laparoscopic vs. open resections for colorectal adenocarcinoma over a ten-year period [Ｊ]. Dis Colon Rectum, 2003; 46(5)∶601.
15. 　Gutt CN, Kim ZG, Schmandra T, et al. Carbon dioxide pneumoperitoneum is associated with increased liver metastases in a rat model [Ｊ]. Surgery, 2000; 127(5)∶566.
16. 　Schneider C, Jung A, Reymond MA, et al. Efficacy of surgical measures in preventing port-site recurrences in a porcine model [Ｊ]. Surg Endosc, 2001; 15(2)∶121.
17. 　Zmora O, Gervaz P, Wexner SD. Trocar site recurrence in laparoscopic surgery for colorectal cancer [Ｊ]. Surg Endosc, 2001; 15(8)∶788.
18. 　Gervaz P, Pikarsky A, Utech M, et al. Converted laparoscopic colorectal surgery [Ｊ]. Surg Endosc, 2001; 15(8)∶827.
19. 　赵国良, 张英豪, 薄涛. 心功能Ⅱ级患者行低气腹压腹腔镜胆囊切除术18例临床分析 [Ｊ]. 中国普外基础与临床杂志, 2005; 12(6)∶568.
20. 　于永扬, 杨烈, 周总光, 等. 腹腔镜全直肠系膜切除保肛术后生活质量评估 [Ｊ]. 中国普外基础与临床杂志, 2007; 14(5)∶524.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic Resection for Colorectal Neoplasms (Report of 18 Cases )

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