OBJECTIVETo study the application of hand-assisted laparoscopic surgery (HALS) in colorectal carcinoma resection.

METHODSFourteen patients with colorectal carcinoma underwent resection by HALS.

RESULTSHand-assisted laparoscopic right hemicolectomy was performed in 6 of 8 ascending colon cancer patients, spending an average of 160 minutes (110 to 220 minutes) for the procedure. The amount of bleeding was 40 approximately 100 ml. Bowel sounds resumed in 36 approximately 72 hours after the operation. The average interval between the operation and patients' discharge was 8 days (7 to 12 days). For 2 patients the surgeons had to resort to laparotomy. All patients received postoperative chemotherapy. Hand-assisted laparoscopic abdominoperineal resection was performed in 5 of 6 patients with lower rectal cancer, with the average duration of 180 minutes (120 to 270 minutes), with bleeding of 40 to 80 ml. Bowel sounds resumed within 24 to 72 hours and the average discharge interval was 14 days (12 to 18 days). The urinary catheter in 6 patients was removed in 7 to 8 days after the operation. All patients with rectal carcinoma received postoperative chemotherapy and radiotherapy. One patient was shifted to laparotomy because of extensive adhesion in the pelvic cavity. Four of 11 patients treated by HALS experienced slight pain in the incision. No other complications were observed in any of the patients. Remote results await further follow-up.

CONCLUSIONHand-assisted laparoscopic surgery in the treatment of colorectal carcinoma, a safe and simple procedure, not only ensures the clearance of tumor, but also reduces operative trauma and hastens recovery.