INITIAL EXPERIENCE WITH THE USE OF LAPAROSCOPIC SURGERY IN THE MANAGEMENT OF COLORECTAL TUMOURS

Анотація

To assess operative outcomes of laparoscopic surgery in colorectal cancer.Materials and methods: This is the outcome of treatment of colorectal cancer patients who were managed in the abdominal surgery department of "VOKOD" from April 2015 to April 2016, and underwent laparoscopic surgery for their treatment. All the patients had histopathological confirmation of their diagnosis. The patients received preoperative preparation and subsequently definitive surgery.A total of 25 patients (10 males and 15 females) had laparoscopic surgery within the period under review. The median age was 62.33±2.27 years. There were 9 resections of the sigmoid colon, 6 low anterior resections, 2 left-sided hemicolectomies , 6 rightsided hemicolectomies, 2 resections of the rectosigmoid colon.Results: 9% of patients had Grade I, 62% had Grade II and 29% had Grade III disease according to histopathological grade. The stage of disease was classified using Dukes classification; Dukes A-14%, Dukes B-27%, Dukes C-54%, Dukes D-5%. The average duration of surgery was 197.6±10.9 min with average blood loss of 110 ±19ml. The rate of conversion to laparotomy was 8%. There was no complication of anastomosis and no mortality during the study. Patients had significantly reduced postoperative pain, less postoperative trauma with an earlier restoration of bowel function and rehabilitation.Conclusions: Our initial experience shows that the use of laparoscopic-assisted interventions on colonic and rectal malignant neoplasms is reasonable and appropriate and results in fewer postoperative complications (in agreement with published literature), reduce the severity of pain and decrease requirements for opioid analgesics. Laparoscopic techniques allow performance of surgical intervention in compliance with all the principles of cancer surgery, providing the necessary volumes and clear resection margins. Based on improving medical technology and experience, the duration of laparoscopic surgery will approach that of traditional laparotomy with improvements in quality and long-term results.