Laparoscopic colectomy for colonic neoplasms in a developing country

Aim: To report the outcome of patients treated for colonic neoplasms using a laparoscopic assisted technique since its introduction at the University Hospital of the West Indies, Jamaica.

Subjects and methods: All consecutive patients undergoing laparoscopic assisted colectomy were entered into a prospective database and this data analysed. Data collected included patient demographics, pre-operative diagnosis, operative events, post-operative morbidity and outcome.

Results: Over the thirty-six months period July 1, 2005-December 31, 2005 and July 1, 2006-December 31, 2008, thirty patients each underwent laparoscopic assisted colectomy for a colonic neoplasm. Their mean age was 63 years with M: F ratio of 1:2. Seventy-four per cent of the patients had carcinomas which was located on the right and sigmoid colon in 17 and 10 patients respectively. Mean operative time was 98 min for patients with right-sided lesions and blood loss for the entire group was minimal. Two patients were converted to open resections. Median duration of hospitalization was five days. There was no mortality but three patients had complications. After median follow-up of 30 months, there was no local or systemic recurrence.

Conclusions: Appropriately selected patients with colonic neoplasms can be safely subjected to a laparoscopic assisted resection and expect to enjoy the advantages of this technique even in a developing country setting. The outcome of thirty consecutive laparoscopic assisted colectomies is reported demonstrating that this technique can be safely applied to selected patients with colonic carcinomas in developing countries.