Author/Editor		Szinicz, G; Mueller, W; Zerz, A; Glaser, C; Beller, S; Rechner, J
Title		Minimally invasive colorectal surgery
Translated title		Minimalno invazivna kolorektalna kirurgija
Type		članek
Source		Endoskopska revija
Vol. and No.		Letnik 4, št. 9
Publication year		1999
Volume		str. 81-91
Language		eng
Abstract		Background. Although nine years have passed since the minimally invasive technique was first used in colorectal surgery, this method still arouses controversy at present. On the basis of our experience with 251 laparoscopic and laparoscopically assisted colorectal operations, we have attempted to appraise the current status in this field. Methods. We analysed restrospectively the morbidity and mortality. 5-year survival, operating time, percentage of conversions and duration of hospital stay. Minimally invasive colorectal opeations were compared with classical operations performed in the same period, with data from the literature and with our results from the years 1990-1991. Special emphasis was placed on oncologic resections. Results. From March 1992 to August 1998, five surgeons performed 251 laparoscopically assited colorectal operations, which represented 62% of the total of 402 colorctal procedures performed in that period. The average age of the patients was 62 years (21-88). Benign diseases were present in 137 patients and malignant ones in 114. The overall complications rate was 23.5%, including a low subset of non-surgical complications (7.2%). Only one patient died after laparoscopy. So laparoscopy carried a mortality rate of 0.4%, whereas the mortality of all 402 patients was 3.7%, and that of cancer patients was 4.5%. The everage operating time was 135 minutes (65-210); a coloproctomucosectomy that lasted 405 minutes is not included in this figure. Conversion to the classical technique was necessary in 8 cases (3.2%). Fifty-nine cancer patients had the following 5-year survival rates: Dukes A (n=9) 100%, B(11) 82%, C(17) 35%, D(21) 9%. Conclusions. Compared to the published results, our data are quite satisfactory, especially with regard to mortality, non-surgical complications, the number of conversions, operating time and the duration of hospital stay. (Abstract truncated at 2000 characters).
Summary		Po devetih letih, ko je bila napravljena prva kolorektalna operacija z uporabo minimalno invazivne tehnike, se o tej metodi še vedno razpravlja. Na osnovi izkušenj z 251 laparoskopskimi in laparoskopsko asistiranimi kolorektalnimi operacijami skušamo oceniti trenutno stanje na tem področju. Metode. Retrospektivno smo analizirali obolevnost in smrtnost, petletno preživetje, trajanje operacije, odstotek preklopov in trajanje hospitalizacije. Minimalno invazivne posege smo primerjali tudi s klasičnimi operacijami v istem časovnem obdobju, primerjavo smo napravili tudi s podatki v literaturi in z našimi rezultati v letih 1990 in 1991, s posebnim poudarkom na operacijah zaradi rakastih obolenj. Rezultati. Od marca 1992 do avgusta 1998 je pet kirurgov opravilo 251 laparoskopskih in laparoskopsko asistiranih kolorektalnih operacij (62% od celotnega števila 402). Povprečna starost bolnikov je bila 62 let (od 21 do 88). 137 bolnikov je imelo benigne, 114 pa maligne bolezni. V celoti smo registrirali zaplete v 23,5%, upoštevajoč tudi nekirurške zaplete, ki jih je bilo 7,2%. Le en bolnik je umrl po laparoskopski operaciji, kar znaša 0,4%, medtem ko je bila smtrnost pri vseh 402 bolnikih 3,7%, pri bolnikih z rakasto boleznijo pa 4,5%. Povprečno trajanje operacije je bilo 135 minut (65 do 210(, le koloproktomukozektomija je trajala 405 minut. Le osemkrat (3,2%) je bil izvršen preklop v klasične tip operacije. Petletno preživetje smo lahko ugotovili za 59 bolnikov z rakom: Dukes A (n=9) 100%, Dukes B (9) 82%, Dukes C (17) 35%, Dukes D (21) 9%. Zaključki. Naši rezultati so v resnici zadovoljivi, če jih primerjamo s podatki iz literature. To velja predvsem za msrtnost, nekirurške zaplete, število preklopov, trajanje operacije in trajanje hospitalizacije. Minimalno invazivna kolorektalna kirurgija je izvedljiva z majhnim odstotkom potrebe po preklopu. Trajanje operacije je odvicno od izkušenj kirurga. (Abstract truncated at 2000 characters).
Descriptors		SURGERY, ENDOSCOPIC LAPAROSCOPY COLONIC DISEASES RECTAL DISEASES TREATMENT OUTCOME AUSTRIA PHYSICIAN'S PRACTICE PATTERNS