J.Jpn. Surg. Soc.. 100(12): 796-800, 1999

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Feature topic

LAPAROSCOPIC BOWEL RESECTION FOR EARLY COLON CANCER

Following the successful introduction of laparoscopic cholecystectomy, many reports confirming the feasibility of using laparoscopy for bowel resection and predicting that it would be advantageous in terms of its minimal invasiveness have been published. In the context of cancer treatment, however, the feasibility of lymphadenectomy, the risk of recurrence, and survival have ernerged as major concerns. Even though mucosal cancer (Tis) can be treated by endoscopic resection (ER), when this is not possible open surgery (OS) must be performed. In patients with T1 cancer, tumors showing slight submucosal layer invasion (sm 1) can be treated in the same way as Tis (in cancer) cancers. But 5％ to 10％ of patients with T1 cancer have massive submucosal layer invasion (sm 2-3) with paracolic lymph node metastasis. At least partial bowel resction with paracolic lymphadenectomy is considered necessary for T1 (sm 2-3) cancers in principle.
In summary, Iaparoscopic local excision of Tis cancers that are endoscopically unresectalbe and laparoscopically assisted partial resection with paracolic lymphadenectomy for T1 cancers have become accepted because local excision and partial resection with paracolic lymphnedectomy are fairly simple to perform laparoscopically. Therefore as a stratgy for the treatment of early colorectal cancer (CRC), minimally invasive loparoscopic bowel resection (LBR) has been positioned between endoscopic resection (ER) and oper surgery (OS).
While the difficulty of performing radical lymphadenectomy is considered one of the greatest obstracles to the introduction of loparoscopic bowel resection (LBR) for the treatment of advanced colorectal cancer (CRC), early colon cancer is a good indication for laparoscopic bowel resection.

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