Laparoscopic techniques are being applied to the surgical management of the colorectal disease. Comparing our twenty-month experience in laparoscopic colectomy with that of the conventional(open) colectomy, we evaluate the efficacy and the safety
of
laparoscopic operations in colorectal disease.
From April 1994 to December 1995, thirty-five patients underwent a colorectal surgery at St. Vincent's Hospital, the Catholic University of Korea, College of Medicine. Nineteen patients(5 males and 14 females; mean age 54.8 years) were included
in
the
laparoscopic group and fourteen patients(5 males and 9 females; mean age 50.9) were included in the open group. Two conversion cases were excepted due to unfitness for comparison. Malignancy were 15 cases in the laparoscopic group and 9 cases in
the
open group. To estimate the general advantage of laparoscopic surgery, we compared durations of wound pain and ileus, postoperative hospital stays, and operative time between two groups. Then surgical margins and number nodes harvested were
compared
between two group for an evaluation of radical curability of malignant disease. The operative procedures of two groups included abdominoperineal resection, anterior resection, low anterior resection, sigmoid colectomy, right hemicolectomy, and
Hartmann's procedure. The conversion rate of laparoscopic colectomy was 9.5%(2 of 21). In the laparoscopic group, we experienced some advantages in duration of pain and ileus, and postoperative hospital stays, even though there was no statistical
significance. Comparable surgical margins and numbers of lymph nodes harvested proved the laparoscopic procedures to be worthy of radical surgery. Between two groups, morbidity and mortality showed no difference. Although the operative time of
the
lapoaroscopic group was longer than that of the open group, it can be decreased with more experience, development of better instruments, and specialization.
Even if we require a further evaluation for survival, our data suggest that the laparoscopic colectomy can be accomplished effectively and safely with the accumulation of experience and the advancement of equipments.
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