Laparoscopic surgery of colon cancer in the practice of coloproctology department

Abstract

Introduction. The incidence of colorectal cancer remains high and has a tendency to increase. Colorectal cancer is third in prevalence in men and second in women. In the structure of cancer mortality, this nosology takes fourth place. In the Re-public of Belarus, according to data for 2016, the incidence of colon cancer was 31.6 per 100,000 population. Mortality from colorectal cancer is about half the incidence, and therefore the prognosis is considered relatively favorable. The proportion of radically operated patients with colorectal cancer and the proportion of patients who have been under observation for 5 years or more since the diagnosis was established tend to increase. Despite the positive trends, an increase in morbidity is still observed, and the mortality rate, 5-year survival rate and one-year mortality rate are still not acceptable. Aim. Introduction into clinical practice and gaining own experience of laparoscopic surgical interventions for colon cancer. Materials and methods. 15 patients with colon cancer were operated on at the proctology department of the Vitebsk Re-gional Clinical Specialized Center. The diagnosis of colon cancer was endoscopically confirmed with morpho-assessment. The age of the patients was 64 ± 8.8 years, body mass index (BMI) – 25.6 kg / m2. There were nine men (60%), six women (40%). 11 patients (73.3%) had comorbid pathology in the stage of compensation. Anesthetic risk for ASA 2.5 ± 0.5. Right colectomy was performed in 4 patients, leftcolectomy in 2 patients, sigmoidcolon resection in 7 patients, resection of rec-tosigmoid compound in 2 patients. The volume of lymphadenectomy was D2 in all patients. Results and discussion. All 15 patients successfully completed laparoscopic colon resection for cancer. A long duration of operations was noted, while they were accompanied by small blood loss in most cases. A stapler anastomosis was applied in 8 patients, manual in 7 patients. Preventive ileostomy was not superimposed. There was no postoperative mortality. All patients underwent multicomponent anesthesia, supplemented by prolonged epidural anesthesia. Conversion to laparotomy was required in one case. 3 (20%) patients developed mild complications of I and II class. One patient (6.7%) developed severe grade V complication. The duration of postoperative intensive care in the ICU and the postoperative period were short. Fast recovery of bowel function was noted. Conclusion. Radical laparoscopic resection for colon cancer reasonable and technically feasible from the standpoint of oncological radicalism. These interventions show good immediate results and should be more widely used in clinical practice.