[Laparoscopic surgery of rectal carcinoma].

Laparoscopic colorectal procedures for treatment of benign disorders are increasingly appreciated. However, laparoscopic resections for rectal cancer are controversial. In the Department of Surgery at the Medical University of Lübeck 25 patients with rectal cancer were treated by laparoscopic procedures within four years. Using four trocars the intraabdominal dissection of the sigmoid colon and rectum including mobilisation of the left flexure were performed. A complete lymphadenectomy with high ligation of the inferior mesenteric artery and dissection of the mesocolon and colon were accomplished by laparoscopic techniques. There was no case requiring conversion to open surgery attributable to intraoperative complications. Apart from stoma complications one venous bleeding occurred postoperatively requiring laparotomy. The median lymph node harvest were 12 nodes. Laparoscopic colorectal surgery for rectal cancer is oncologically feasible. Concerning long-term outcome and due to the problem of port site recurrences laparoscopy for rectal cancer should be offered only to patients enrolled in a prospective randomized trial.