Introduction: The first colon resection for cancer was completed in late 1990. Multiple problems subsequently reported by others had been initially addressed early in this study. Intracorporeal anastomosis, lesion localization, and method for prevention of port site recurrences was all defined and resolved early in our experience.
Patients and Methods: This report details the long term outcome of 276patients who have undergone laparoscopic colon resection for carcinoma; including 35 (12.68%)with stage I, 106 (38.40%)with stage II, 93 (33.69%)with stage III, and 42 (15.21%) with stage IV disease. The overall follow-up encompasses data on 90.21% (247)patients, Twenty-nine (9.79%) patients are lost to follow-up, and 13of them are not dead according to tumor board statistics.
Results: Current data includes 53(21.47%)patients who are 5yearsor more post-operation; 106 (42.91%)patients who are under 5 years but over 2 yearspost-operation, and 88 (35.62%)who are less than 2 yearspost-operation with a mean follow up of 33.97months in the entire series. The peri-operative death rate (less than 30 days) was 1.44%, most dying of cardiopulmonary related complications; almost all of who were refused open surgery. The recurrence rate of carcinoma was 2.85%(1 patient)in stage I, 10.37% (11 patients)in stage II, 13.97% (13 patients)in stage III. The average survival of stage IV patients was 23.7months. There have been no trocar site implants, and the wound complication rate early and late has been 1.08%(1 early infection, 2 late infection at colostomy closure site).
Conclusion: Laparoscopic colon resection for carcinoma in experienced hands appears to be safe. The overall complication rate, death and recurrence rate seems to be less than that reported in large open series. It is imperative that those undertaking this type of surgery have adequate experience in open surgery as well as laparoscopic experience with benign disease prior to approaching carcinoma.
