Colorectal surgery in a community hospital setting: have attitudes changed because of laparoscopy? A general surgeons' last 5 years experience review.

INTRODUCTION

Laparoscopy is rapidly emerging as the preferred surgical approach to a number of different diseases because it permits a correct diagnosis and accurate treatment; however, it is not yet being applied in a widespread manner in the management of benign or malignant colorectal disease. The aim of this work is to illustrate retrospectively the results of our experience of laparoscopic colorectal surgery carried out in a community hospital over the last 5 years to document its feasibility, safety, and benefits when carried out by general surgeons in this setting.

MATERIALS AND METHODS

Between January 2003 and December 2007 a total of 628 patients underwent a colorectal procedure. Among them, 328 (52.2%) were operated on with a laparoscopic approach.

RESULTS

In 12 cases, we had to convert to the open approach. Major complications occurred in 3.6% whereas minor occurrences occurred in up to 10%.

CONCLUSIONS

Even if limited by its retrospective design, our experience exhibits that the laparoscopic may well be a safe and effective approach to colon pathology in a community hospital setting. Such features make laparoscopy a challenging alternative to open surgery in the approach to colon disease and it can be proven to be cost-effective without undue risk, as long adequate laparoscopic training is undertaken by the surgeon and proper preparation observed.