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Intraoperative Difficulties and the Reasons for Conversion in Patients Treated with Laparoscopic Colorectal Tumors

100%
Tarnowski W., Uryszek M., Grous A., Dib N.
Polish Journal of Surgery
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2012
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vol. 84
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issue 7
352-357
EN
The aim of the study was an evaluation of conversion causes and intraoperative difficulties in patients treated with laparoscopic surgery due to colorectal tumours on the basis of authors' own material.Material and methods. in the period 2009-2012 160 patients were operated on because of large bowel cancer, 79 women and 81 men. Average age of patients was 66 years. The conversion was recognized as desuflation of peritoneal cavity, trocars removal and making laparotomy.Results. The conversion was made in 22 cases (13,7%). More in men (16.1%) than in women. The conversion was made twice as likely in T3 and T4 tumors than in T1 and T2.Conclusions. The main cause of conversion in laparoscopic operations of colorectal cancer is local tumor progression.
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Laparoscopic Abdominoperineal Resection Of The Rectum – How Is It Done; Initial Results

88%
Grous A., Uryszek M., Ciesielski A., Dib N., Tarnowski W.
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vol. 85
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issue 10
569-575
EN
The abdominoperineal resection of the rectum is a classical operation performed in case of patients diagnosed with rectal cancer. The development of laparoscopic techniques in recent years, introduced yet another method of treatment, considering patients with rectal cancer- laparoscopic abdominoperineal resection of the rectum. The aim of the study was to present initial treatment results considering the above-mentioned patients. Material and methods. The study group comprised 25 patients (16 male and 9 female) diagnosed with low-rectal cancer, subjected to surgery by means of the above-mentioned method. Mean patient age amounted to 66 years. Three (12%) patients required conversion to classical surgery (laparotomy), while one patient required reoperation, due to presacral vascular bleeding. Complications were observed in 10 (40%) patients. Average hospitalization was 7 days. In case of all patients the radial margin was negative, and mean number of removed lymph nodes amounted to 9.6. Mortality was not observed during the perioperative period. Due to the initial character of the study analysis (mean observation period in case of 68% of patients was shorter than 2 years), oncological results were not subject to evaluation. Conclusions. Laparoscopic abdominoperineal resections are considered as technically difficult operations, requiring significant experience of the operating team. However, they enable the patient to take advantage of the many assets of minimally invasive surgery, with comparable rates of postoperative complications.
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