Strategy for Obstructive Colorectal Cancer with Laparoscopic Surgery

Abstract

We reviewed 113 patients with resected obstructive colorectal cancer between January 2002 and February 2012. Emergency surgery was applied in patients with severe condition, long-term disease and rigid feces in the colon. Surgery was performed in the remaining mild condition patients within 7 days after decompression. Primary anastomosis was done in the cases in whom on table lavage was effective and who were suitable for anastomosis. Laparoscopic surgery was applied in patients with good working intraperitoneal space after decompression, excluding cases with several large, invaded or concomitant metastatic cancer of the lymph nodes. All cases were divided into 54 open surgery cases and 59 laparoscopic cases for assessment of morbidity and prognosis. There were no surgery-related deaths, and the laparoscopic conversion rate was 3.4%. The patients in the laparoscopic group, even at stage IV or higher, had significantly less operation time, less bleeding, fewer complications, and a shorter hospital staying after surgery compared with the patients in the open surgery group. We reported no difference in anastomotic leakage between the two groups and no bowel obstruction after surgery in the laparoscopic group (p<0.01). There was no difference in the overall five year survival rate between both groups. We concluded that our strategy of treatment for obstructive colorectal cancer was appropriate.