Rekto-sigmoid kanserlerde laparoskopik cerrahi: İlk sonuçlarımız

Laparoskopik kolorektal cerrahi 1990 yılından beri başarıyla uygulanmaktadır. Bir çok çalışmada gerek morbidite gerekse mortalite yönlerinden açık cerrahiye eşdeğer olduğu, hatta beraberinde bazı avantajlar sağladığı savunulmaktadır. Konuyla ilgili ilk deneyimlerimizi sunmak amacıyla 2002-2004 yılları arasında laparoskopik kolorektal cerrahi uyguladığımız 6'hasta histopatolojik sonuçları, morbidite-mortalite oranları ve takipleri yönünden incelendi. Sonuçta laparoskopinin kabul edilebilir morbidite ve mortalite oranlarına sahip olduğu, hasta konforu ve teknik açılardan bazı avantajlar sağladığı, tak operasyon süresinin uzaması gibi dezavantajlarının da bulunduğu tespit edildi.

Anahtar Kelimeler:

Kolorektal cerrahi, Karsinom, Laparoskopi

Laparoscopic surgery for recto-sigmoidal carcinoma: Preliminary results

Laparoscopic colorectal surgery has been performed successfully since 1990. It has been advocated that it presents Similar results compared to open surgery on both morbidity and mortality. Moreover it has some advantages. In order to esent our first experiences on this subject, we investigated 10 patients who were undergone laparoscopic colorectal surgery on histopathological results, morbidity and mortality rates and follow-ups. It was concluded that laparoscopy has fqclmittable morbidity and mortality rates, presents some advantages on patient comforts and technical situations, but has üso some disadvantages like prolongation of the operation period.

Keywords:

Colorectal Surgery, Carcinoma, Laparoscopy,

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1. Wu JS, Birnbaum EH, Fleshman JW ‘’et al’’. Early experience with laparoscopic abdominoperineal resection. Surg Endosc 1997; 11:449-455.
2. Sackier JM. Laparoscopic abdominoperineal resection. Br J Surg 1992; 79: 1207-1208.
3. Alexander, R.J.T., Jaques, B.C., Mitchell, K.G.: Laparoscopically assisted colectomy and wound recurrence. Lancet 341:249, 1993
4. Molenaar CBH, Bijnen AB, de Ruiter P ‘’et al’’. Indications for laparoscopic colorectal surgery: Results from the Medical Center Alkmaar, The Netherlands Surg Endosc 1998; 12:42-45.
5. Köckerling F, Scheidbach H. Current status of laparoscopic colorectal surgery. Surg Endosc 2000; 14: 777-778.
6. Begos DG, Ballantyne GH. Laporoscopic colon and rectal surgery at a VA Hospital analysis of the first 50 cases. Surg Endosc 1996; 10:1050-1056.
7. Fazio WV.,Kostner-Lopez F. Role of laparoscopic surgery for treatment of early colorectal carcinoma. World J Surg 2000; 24: 1056-1060.
8. Bergamaschi R.,Arnaud JP ‘’et al’’. Immediately recognizable benefits and drawbacks after laporoscopic colon resectin for benign disease. Surg Endosc 1997; 11: 802-804.
9. Tomita H, Marcello PW, Milsom JW ‘’et al’’. Laparoscopic surgery of the colon and the rectum. World J Surg 1999; 23: 397-405.
10. Fielding GA, Lumley J, Nathanson L. Laporoscopic colectomy. Surg Endosc 1997; 11: 745-749.
11. Patankar S, Sergio L, Andrea F ‘’et al’’. Propective comparison of laporoscopic vs open resections for colorectal adenocarcinoma over a ten year period. Dis Colon Rectum 2003; 46(5): 601-611.
12. Yamamato S, Watanabe M, Hasegawa H ‘’et al’’. Prospective evoluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. Dis Colon Rectum 2002; 45(12): 1648-1654.
13. Lechaux D, Trebuchet G, Calve JL. Five –year results of 200 laparoscopic left colectomies for cancer. Surg Endosc 2002;16:1409-1412.
14. Botoman VA, Pietro M, Thirbly RC ‘’et al’’. Localization of colonic lesions with endoscopic tattoo. Dis Colon Rectum 1994; 37:775.
15. Lehman GA, Maveety PR, O’Connor KW ‘’et al’’. Mucosal clipping-utility and safety testing in colon. Gastrointest. Endosc 1985;31:273.
16. Gervaz P, Pikarsky A, Utech M ‘’et al’’. Converted laporoscopic colorectal surgery. Surg Endosc 2001;15:827-832.
17. Köckerling F, Schneider C, Reymond MA ‘’et al’’. Early results of a prospective multicenter study on 500 consecutive cases of laparoscopic colorectal surgery. Surg Endosc 1998;12:37-41.
18. Garrard CL, Clement RH., Nanney L. Adhesion formation is reduced after laparoscopic surgery. Surg Endosc 1999; 13:10-13.
19. Tittel A, Schippers E, Anuroy M. Shorter postoperatif atony after laparoscopic-assisted colonic resection? Surg Endosc 2001;15:508-512.
20. Lacy AM. Laparoscopy may be better than open colecyomy for colon cancer. Lancet 2002; 359:2224-2229.
21. Targorana EM, Gracia E, Carriga J ‘’et al’’. Prospective randomized trial comparing convantional laparoscopic colectomy with hand assisted laporoscopic colectomy. Surg Endosc 2002; 16:234-239.
22. Lin KM, Ota DM Laparoscopic colectomy for cancer:an oncologic feasible option. Surg oncology 2000; 9:127-134.
23. Lopez Ballesta C, Cid JA., Powes I. Laparoscopic surgery in the elderly patients. Surg Endosc 2003;17:333-337.
24. Lezoche E., Feliciotti F, Paganini AM ‘’et al’’. Laparoscopic vs open hemicolectomy for colon cancer. Surg Endosc 2002; 16:596-602.
25. Ordemann J, Jacobi CA, Schwenk W ‘’et al’’. Cellular and humoral inflammattory response after laparoscopic and conventional colorectal resections. Surg Endosc 2001;5:600-608.
26. Forde KA, Hulten L. Laparoscopy in colorectal surgery. Surg Endosc 1996; 10:1039-1040.
27. Braga M, Vignali A, Zuliani W ‘’et al’’. Training period in laparoscopic colo-rectal surgery. Surg Endosc 2002; 16:31-35.
28. Scheidbach H, Schneider C, Kondradt J ‘’et al’’. Laparoscopic abdominoperineal resection and anterior resection with curative intent for carcinoma of rectum. Surg Endosc 2002;16:7-13.
29. Scheidbach H, Schneider C, Huegel O ‘’et al’’. Laparoscopic sigmoid resection for cancer:curative resection and preliminary medium term results; Dis Colon Rectum 2002; 45(12):1641-1647.
30. Franklin ME, Rosenthal D, Medina AD ‘’et al’’. Prospective comparison of open vs laparoscopic colon surgery for carcinoma:five year results. Dis Colon Rectum 1996;39:35.
31. Fleshman SW, Nelson H, Peters WR ‘’et al’’. Early results of laparoscopic surgery for colorectal cancer. Dis Colon Rectum 1996;39:53.
32. Kwok SP, Lau WY, Carey PD ‘’et al’’. Prospective evaluation of laparoscopic assisted large-bowel excision for cancer. Ann Surg 1996; 223:170.
33. Bostancı EB ,Özoul YB, Yol S ‘’ve ark.’’. Laparoskopik abdominoperineal rezeksiyon olgularımızın erken dönem sonuçları (11 olgu).Ulusal Cerrahi Dergisi 2004; 20 (2): 71-77.