A study evaluating the safety of laparoscopic radical operation for colorectal cancer

摘要

Aim:This study aimed to assess the safety and feasibility of laparoscopic curative resection for colorectal cancer through the clinical practice and basic research.Material and Methods:From September 2001 to September 2002, 47 patients with colorectal cancer were treated using laparoscopic approach, compared with 113 patients underwent traditional operation. The length of intestinal segment excised, size of tumour, clearance of lymph nodes, local recurrence and distant metastasis rate during the period of follow-up in both groups were compared. The other part of the study involved the detection of exfoliated tumour cells in the peritoneal washing before and after surgery; flushing of the instruments was performed in both groups and the results compared. For the laparoscopic cases, the filtrated liquid of CO2 pneumoperitoneum was also checked for tumour cells.Results:No significant differences existed in tumour size, operative site and manner between the two groups. The exfoliated tumour cell was not detected in the CO2 filtrated liquid. Between both groups there was no difference in the incidence of exfoliated tumour cells in peritoneal washing before and after surgery as well as in the fluid used for flushing the instruments. The total number of lymph nodes harvested was 13.71±9.57 for the laparoscopic group and 12.10±9.74 for the traditional procedure. Similar length of colon was excised in both groups; this was (19.38±7.47) cm in the laparoscopic and (18.60±8.40) cm in the traditional groups. The distal margins of resection for rectal cancer were (4.19±2.52) cm and (4.16±2.00) cm respectively. The local recurrence rate was 2.13% (1/47) and 1.77% (2/113) with the distant metastasis rate 6.38% (3/47) and 6.19% (7/113) respectively. Both the statistics were comparable between the laparoscopic and traditional surgery for the colorectal cancer.Conclusion:Laparoscopic curative resection for colorectal cancer can be performed safely and effectively. In the treatment of colorectal malignancy, laparoscopic resection can achieve similar radicalilty as compared to the traditional laparotomy.