[Three hundred laparoscopic colorectal operations--safety, levels of difficulty and survival].

Introduction: The accumulated data in recent years on the safety of laparoscopy in colorectal cancer patients encourage more surgeons to use this approach for different colorectal pathologies. However, laparoscopic colorectal surgery consists of different heterogeneous complex procedures that necessitate extensive experience and laparoscopic surgical skills

Purpose: To evaluate safety, levels of difficulty and oncological outcome in a consecutive series of patients that underwent elective laparoscopic colorectal surgery during a 5-year period.

Methods: Evaluation of our prospective collected data of patients that underwent laparoscopic colorectal surgery during a 5-year period by our surgical team.

Results: A total of 300 patients were operated on electively for different indications during this time period. Indications for surgery included cancer (58%), benign polyps (16%), Crohn's disease (6%), diverticular disease (10%) and others (10%). Operations for diverticular disease were associated with higher conversion rates and operative times. The mortality rate was 0.3% (one patient). There were 4.6% major surgical complications that necessitated a second operation and another 4.6% moderate surgical complications that were treated conservatively. Wound infection occurred in 7.2% of all patients. The conversion rate was 14.3%. A total of 171 patients underwent operations for curable colorectal cancer. In this group, the mean number of harvested nodes was 16 and 2-year disease-free survival was 87%. Stage I patients had no recurrent disease during follow-up time.

Conclusions: Laparoscopic colorectal surgery is safe. Immediate oncological results and 2-year survival in colorectal cancer patients, as demonstrated in our study, are adequate and comparable to the open approach. The authors believe that adequate results in laparoscopic colorectal operations can be achieved by a dedicated laparoscopic colorectal team.