[Laparoscopic surgery of XXXX : state of art and long-term results].

@entity5 @entity1 @entity834
BACKGROUND: From the first laparoscopic colectomy that we performed 18 years ago, several studies showed equivalent oncologic results of this technique compared to open surgery Despite this evidence traditional surgeons remain skeptical in the use of this technique, although it may favor an early return of bowel function and therefore a shorter hospitalization, as reported in recent comparative studies. Many colorectal surgeons, who have appreciated the advantages of laparoscopic colectomy, extended this approach also in @entity5 , finding a better view in the pelvis during dissection. METHOD: From 1992 to july 2009 we performed more than 400 laparoscopic resection and amputation for @entity5 . One hundreds eighteen @entity1 (TNM stage I-III) with a 36 month minimum follow-up were enrolled in this analysis. Converted @entity1 to open surgery and @entity1 staged as iT1N0 are not present in this series because we treat with local excision by TEM. RESULTS: Mean operative time was 160 minutes (90-265). Mortality was 1% in 186 @entity1 and conversion rate was 1.5%. Major complications occurred in 10.7%, including @entity834 in 14 @entity1 (7.5%) and mean hospital stay was 7.7 days. With a mean follow up of 96.8 (36-175) months in the stage I-III, the local recurrence rate was 12.5%. Systematic recurrence occurred in 13.1%. CONCLUSION: Laparoscopic resection in @entity5 would allow the use of the same Heald's technique, respecting the Heald's principle of meticulous dissection during total mesorectal excision, furthermore we are waiting 5 years data from randomized trials (COLOR II and CLASICC).
