INITIAL EXPERIENCE WITH THE USE OF LAPAROSCOPIC SURGERY IN THE MANAGEMENT OF COLORECTAL TUMOURS
Keywords:
rectal cancer, colon cancer, laparoscopic surgeryAbstract
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.
References
Кохнюк, В.Т. Колоректальный рак / В.Т. Кохнюк. - Минск.: Харвест, 2005. - 384 с.
Имянитов Е.Н. Клинико-молекулярные аспекты колоректального рака: этиопатогенез, профилактика, индивидуализация лечения//Практическая онкология2005-№2.-Т.6.-С.65-70
H.Jaap Bojer,M.D., Ph.D.,Charlotte L. Dejen, et al. A Randomized Trial of Laparoscopic versus Open Surgery for Rectal Cancer//The New England Journal of Medicine.-2015.-372:1324-1332 April 2,2015
Денисенко, В.Л. Проблемы и перспективы хирургического лечения острых осложнений колоректального рака // В.Л. Денисенко, Ю.М. Гаин, С.В. Шахрай / Вестник Национального медико-хирургического центра им. Н.И. Пирогова. – 2012. – № 3, т.7. –с. 36-43.
Суконко, О. Г. Статистика онкологических заболеваний в Республике Беларусь / О. Г. Суконко, А. Е. Океанов, П. И. Моисеев, Л. Ф. Левин //Минск:РНПЦ ОМР им.Н.Н.Александрова,2015.-204 с.
Шелыгин Ю. А., Ворбьёв Г.И., Фролов С.А. Техника лапароскопических операций при раке толстой кишки.//Практическая онкология .Т.6,№2-2005
Шелыгин Ю. А.,Ворбьёв Г.И.Фролов С.А.,Лощинин К.В.,Сушков О.И. Лапароскопические операции у больных раком прямой кишки//Практическая онкология.Т.№.№2-2002.
Карачун А.М.,Петров А.С.,Самсонов Д.В.,Петрова Е.А. Место лапароскопических операция при раке ободочной и прямой кишок/ Практическая онкология-2012 - №4. -Т13. - С 261.
Anderson C., Uman G., Pigazzi A. Oncologic outcomes of laparoscopic surgery for rectal cancer: a systematic review and meta-analysis of the literature//European Journal of Surgical Oncology 2008.-P- 1135-1142.
Воробьёв Г.И., Шелыгин Ю.А., и др. Непосредственные результаты лапароскопических передних резекций прямой кишки по поводу рака//Эндоскоп.хир.-2003.-№1.-С14–19
Воробьёв Г.И.,Шелыгин Ю.А.,Фролов С.А и др. Лапароскопические операции у больных раком прямой кишки(сравнительные результаты лапароскопических и открытых передних резекций)//Хирургия-2003 -№3.-С.36-42
Yu-Wei Wang.,Li-Yong Huang.,Cheng-Li Song. et al.Laparoscopic vs open abdominal resection in the multimodality management of low rectal cancer//World J Gastroenterol 2015 Sep,21(35):10174-83.
Фёдоров В.Д., Воробьёв Г.И.,Ривкин В.Л. Клиническая оперативная колопроктология: руководство для врачей/М.:ГНЦ проктологии ,1994г.
Ramos J.R. Laparoscopic abdominoperineal resection//New trends in coloproctology. J.A.ReisNeto.- Livraria e Editora Rewinter,2000.-Vol.-P457-472.
Lecbaux D.,Trebucbet G.,Le Calve J.L. Five-year results of 206 laparoskopic left colectomies for cancer//Surg.Endoscop.-2002.-vol.16.-P.1409-1412.