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Abstract：
BACKGROUND: Laparoscopy is one of the major advances in surgery in the last 30 years and has many benefits. Although laparoscopy was initially used for resection of benign colon lesions, it is now widely used for colorectal cancer resections after strong evidence has confirmed its safety and efficacy. We aim to report both the surgical and oncological outcomes of our first series of laparoscopic colorectal cancer resections.
METHODS: In 2013, a laparoscopic colorectal resection service was established in northern Iraq at Zheen Hospital, Erbil. Data from all consecutive colorectal cancers were collected. Patients with locally advanced diseases and those who required emergency operations for bowel obstruction or perforation were excluded. We analyzed demographic, operative, postoperative, and histopathological data for all patients who were included in the study.
RESULTS: A total of 124 patients with colorectal cancers presented to our unit between January 2013 and January 2023. Only 112 patients fulfilled the inclusion criteria and underwent laparoscopic resections. The median age of the patients was 54.5 years. The majority of patients were men (n=62; 55.4%). In 39 patients (35%), the cancer was located in the sigmoid; in 33 patients (29.5%) the cancer was in the rectum. Laparoscopic anterior resection was the most common procedure (n=50; 45%), followed by right hemicolectomy in 17 cases (15.1%). The conversion rate to open surgery was 8% (nine cases). The most common causes of conversion to open surgery were dilated bowel loops and tumour adherence to other structures. The mean operative time was 190 minutes and the mean hospital stay was three days. No complications were reported in 94 patients (84%). Among the complications, wound infection was seen in seven patients (7.8%). There were six anastomotic leaks (6.7%). The mean number of lymph nodes harvested was 13. In 70 patients (62.5%), the lymph node count was ≥12 with a median of 13. The mean distal resection margin was 6 cm and 2.5 cm for colon and rectal resections, respectively.
CONCLUSIONS: This study reveals that laparoscopic resection for colorectal cancers is surgically practicable and safe with the benefits of a short hospital stay, adequate resection margins, and adequate lymph node yield.
METHODS: In 2013, a laparoscopic colorectal resection service was established in northern Iraq at Zheen Hospital, Erbil. Data from all consecutive colorectal cancers were collected. Patients with locally advanced diseases and those who required emergency operations for bowel obstruction or perforation were excluded. We analyzed demographic, operative, postoperative, and histopathological data for all patients who were included in the study.
RESULTS: A total of 124 patients with colorectal cancers presented to our unit between January 2013 and January 2023. Only 112 patients fulfilled the inclusion criteria and underwent laparoscopic resections. The median age of the patients was 54.5 years. The majority of patients were men (n=62; 55.4%). In 39 patients (35%), the cancer was located in the sigmoid; in 33 patients (29.5%) the cancer was in the rectum. Laparoscopic anterior resection was the most common procedure (n=50; 45%), followed by right hemicolectomy in 17 cases (15.1%). The conversion rate to open surgery was 8% (nine cases). The most common causes of conversion to open surgery were dilated bowel loops and tumour adherence to other structures. The mean operative time was 190 minutes and the mean hospital stay was three days. No complications were reported in 94 patients (84%). Among the complications, wound infection was seen in seven patients (7.8%). There were six anastomotic leaks (6.7%). The mean number of lymph nodes harvested was 13. In 70 patients (62.5%), the lymph node count was ≥12 with a median of 13. The mean distal resection margin was 6 cm and 2.5 cm for colon and rectal resections, respectively.
CONCLUSIONS: This study reveals that laparoscopic resection for colorectal cancers is surgically practicable and safe with the benefits of a short hospital stay, adequate resection margins, and adequate lymph node yield.
摘要：
背景：腹腔镜检查是近30年来外科手术的主要进展之一，具有许多益处。尽管腹腔镜最初用于切除良性结肠病变，在强有力的证据证实其安全性和有效性后，它现在被广泛用于结直肠癌切除术。我们的目标是报告我们的第一个系列腹腔镜结直肠癌切除术的手术和肿瘤结果。
方法：2013年，在伊拉克北部的Zheen医院建立了腹腔镜结直肠切除术服务，埃尔比勒.收集来自所有连续结直肠癌的数据。排除患有局部晚期疾病的患者以及因肠梗阻或穿孔而需要紧急手术的患者。我们分析了人口统计，Operative,术后,以及纳入研究的所有患者的组织病理学数据。
结果：在2013年1月至2023年1月期间，共有124例结直肠癌患者进入我们的病房。只有112例患者符合纳入标准并接受了腹腔镜切除术。患者的中位年龄为54.5岁。大多数患者为男性（n=62；55.4％）。在39名患者（35%）中，癌症位于乙状结肠;33例患者(29.5%)的癌症位于直肠.腹腔镜前切除术是最常见的手术（n=50;45％），其次是右半结肠切除术17例(15.1%)。开放手术的转化率为8％（9例）。转换为开放手术的最常见原因是肠loop扩张和肿瘤粘附到其他结构。平均手术时间为190分钟，平均住院时间为3天。94例患者（84%）未报告并发症。在并发症中，7例(7.8%)患者出现伤口感染。有6例吻合口漏（6.7％）。收集的平均淋巴结数为13。在70名患者（62.5%）中，淋巴结计数≥12,中位数为13.结肠和直肠切除的平均远端切缘为6cm和2.5cm，分别。
结论：这项研究表明，腹腔镜结直肠癌切除术在手术上是可行的和安全的，而且住院时间短。足够的切除边缘，和足够的淋巴结产量。
方法：2013年，在伊拉克北部的Zheen医院建立了腹腔镜结直肠切除术服务，埃尔比勒.收集来自所有连续结直肠癌的数据。排除患有局部晚期疾病的患者以及因肠梗阻或穿孔而需要紧急手术的患者。我们分析了人口统计，Operative,术后,以及纳入研究的所有患者的组织病理学数据。
结果：在2013年1月至2023年1月期间，共有124例结直肠癌患者进入我们的病房。只有112例患者符合纳入标准并接受了腹腔镜切除术。患者的中位年龄为54.5岁。大多数患者为男性（n=62；55.4％）。在39名患者（35%）中，癌症位于乙状结肠;33例患者(29.5%)的癌症位于直肠.腹腔镜前切除术是最常见的手术（n=50;45％），其次是右半结肠切除术17例(15.1%)。开放手术的转化率为8％（9例）。转换为开放手术的最常见原因是肠loop扩张和肿瘤粘附到其他结构。平均手术时间为190分钟，平均住院时间为3天。94例患者（84%）未报告并发症。在并发症中，7例(7.8%)患者出现伤口感染。有6例吻合口漏（6.7％）。收集的平均淋巴结数为13。在70名患者（62.5%）中，淋巴结计数≥12,中位数为13.结肠和直肠切除的平均远端切缘为6cm和2.5cm，分别。
结论：这项研究表明，腹腔镜结直肠癌切除术在手术上是可行的和安全的，而且住院时间短。足够的切除边缘，和足够的淋巴结产量。
