Laparoscopic-Assisted Surgery in the Management of Colorectal Cancer: The Surgical Technique and its Evaluation

We describe the basic surgical procedures of laparoscopic-assisted colectomy (LAC) and present our assessment of invasiveness through a comparison of outcomes in patients with colon cancer treated with LAC or open surgery. The technique of LAC includes pneumoperitoneum and intra-abdominal radical dissection above the D1 level. Operative time, blood loss, length of hospitalization,length of the postoperative wounds,and the serum concentration of interleukin(IL)6 24 hours after surgery were assessed in 80 patients treated with LAC and 160 patients who underwent open surgery in our department in the last 4 years. In patients undergoing LAC mean blood loss,postoperative wound length,and serum IL-6 concentrations were significantly less (84 ml,8.4 cm,and 67 pg/ml)but operative time was significantly longer(193 minutes)than in patients undergoing open surgery (220 ml, 19.6 cm, 178 pg/ml, and 150 minutes). Although the degree of invasiveness cannot easily be compared between open surgery and LAC,the lower blood loss and shorter postoperative wound with LAC suggests that it is less invasive. The increase in inflammatory cytokines was slight with LAC. (Jikeikai Med J 2003;50:45-50)