Laparoscopic Colectomy: Technical Considerations.
- Author:
Yu Gene OH
1
;
Yeong Cheol IM
;
Dae Hwa CHOI
;
Hee Jeong CHA
Author Information
1. Deparment of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. driyc@hotmail.com
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Colonoscopic tattoo;
Total mesorectal excision
- MeSH:
Carbon;
Colectomy;
Colorectal Neoplasms;
Incidence;
India;
Ink;
Laparoscopy;
Rectal Neoplasms;
Retrospective Studies
- From:Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2009;12(1):37-43
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Laparoscopic colectomy is technically demanding. Here we share of experience with laparoscopic procedures with focusing on (1) preoperative localization by a colonoscopic tattoo and (2) comparing the laparoscopic total mesorectal excision (lapaTME) with the conventional TME (openTME) according to microscopic examination. METHODS: We retrospectively collected 112 cases of laparoscopic colectomy that was performed for treating colorectal cancer during the past 6 years. Preoperative colonoscopic tattoo was done by using india ink. The tattoo cases were compared with the non-tattoo cases. Comparison between 13 cases of lapaTME and 15 cases of openTME was assessed by both gross and microscopic examination in the 28 cases for 9 months. The lapaTME and openTME were applied to mid-rectal cancer and mid&low rectal cancer, respectively. RESULTS: Tattoo was carried out for the Tis (100%), T1 (92%), T2 (72%), T3 (36%) cases. Of the significant cases, T3 lesion was not identified at laparoscopic colectomy. LapaTME grossly showed a greater incidence of defect than that of openTME, but there was no difference microscopically between lapaTME and openTME. CONCLUSION: A tattoo was useful for early lesion and it should be considered for advanced lesion. LapaTME for mid-rectal cancer can be done without compromising the principles of TME.
