World Journal of Laparoscopic Surgery

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VOLUME 1 , ISSUE 3 ( September-December, 2008 ) > List of Articles


Laparoscopic Surgery for Rectal Carcinoma– An Experience of 20 Cases in a Government Sector Hospital

Asit Arora, Ashok K Mathur, Sameer Gupta, Nisar Ahmed, Akshay Sharma

Citation Information : Arora A, Mathur AK, Gupta S, Ahmed N, Sharma A. Laparoscopic Surgery for Rectal Carcinoma– An Experience of 20 Cases in a Government Sector Hospital. World J Lap Surg 2008; 1 (3):53-57.

DOI: 10.5005/jp-journals-10007-1072

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2008; The Author(s).



To assess feasibility, advantages, oncological safety, cost effectiveness and long term results of laparoscopic surgery for rectal cancer in a government sector hospital.


From January 2005 to May 2007, 20 patients of operable cancer rectum were subjected to laparoscopic curative resection. Surgical technique, postoperative morbidity and clinical results were reviewed in close follow-up for median period of 20 months (12 wks to 30 months).


Fourteen patients underwent LAPR and 6 patients LAR.

Median age was 39 years. Median operating time for Lap APR was 296 minutes, initial 7 cases taking an average of 368 minutes, while subsequent 7 cases average operating time was 232.5 minutes. In Lap AR, average duration of surgery was 356 minutes, first 4 cases taking 400 minutes while for last 2 cases, and mean operating time was 300 min.

There was no intraoperative complication in either group. All patients mobilized on POD: (1) Incidence of PONV was significantly less. Oral feeds were routinely started on POD, (2) Incidence of wound infection was also reduced (2/20). Hospital stay on an average was 11 days as ours being a government sector hospital, patients were discharged only after drain removal and thus stay was slightly prolonged. Of the 20 patients, 17 were diagnosed to be Adenocarcinoma, 2 with Malignant Melanoma and 1 with GIST. Two patients of malignant melanoma developed locoregional recurrence and 2 patients developed distant metastasis after approximately 1 year. No incidence of port metastasis in any patient.


Laparoscopic colorectal surgery is safe, feasible and meets oncologic requirements of radicality. Pattern of local recurrence and distant metastasis is similar to open surgery. Lap surgery has a steeper learning curve. Cost of treatment decreased by use of Ligaclips for intracorporeal vascular control and extracorporeal division of gut whenever possible.

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  1. Goldstein AS. Minimally invasive colon resection (laparoscopic colectomy). Surg Laparos. Endosc 1991;1:144-50.
  2. Systemic cytokine response after laparoscopic assisted resection of rect-sigmoid carcinoma: a prospective randomized trial. Ann Surg 2001;231:506-11.
  3. Prospective evaluation of laparoscopic assisted celectomy in an unselected gp of patients. Lancet 1992;340:831-33.
  4. Outcome of laparoscopic surgery for rectal cancer in 101 patients. Dis Colon Rectum 2003;46:1047-53.
  5. Pr Clinical Outcome of Surgical Therapy Study Group—A Comparison of Laparoscopically Assisted and open celectomy pr colon cancer : N Eng. J. Med 2004;350:2050-59.
  6. Rectal carcinoma may be adequately treated using laparoscopic methods. Semon Colon Rectum Surg 1998;9:254-58.
  7. Total mesorectal excision: assessment of the laparoscopic approach. Dis Colon Rectum 2004;44:315-21.
  8. Minimally invasive surgery for rectal cancer. Surg Clin N. Am 2005;85:61-73.
  9. Laparoscopic resection of rectosigmoid carcinoma. Prospective randomised trial. Lancet 2004;363:1187-92.
  10. Prospective evaluation of laparoscopic surgery for rectosigmoidal and rectal carcinoma. Dis Colon Rectum 2002;45:1648-54.
  11. Early postoperative results of a prospective series of laparoscopic vs open anterior resection for rectosigmoid cancers. Dis Colon Rectum 1997;40:776-80.
  12. Laparoscopic APR early postoperative results of a prospective study involving 116 patients. Dis Colon Rectum 2000;43:1503-11.
  13. Assessing the relative costs of standard open surgery and laparoscopic surgery in colorectal cancer in a randomised controlled trial in UK. Crit Rev Oncol Hematol 2000;33:99-103.
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