Invited Commentary

Fabrizio Michelassi, MD
Arch Surg. 1997;132(7):765. doi:10.1001/archsurg.1997.01430310079016.
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The study by Leung et al shows that laparoscopic-assisted resection of rectosigmoid adenocarcinoma is technically feasible and safe and that the oncological clearance can be as satisfactory as that obtained during an open procedure. The authors also suggest that their study shows a significant reduction in postoperative analgesic requirements and shorter hospitalization when compared with a matched historical group of patients who underwent conventional open surgery. All these benefits were at the expense of a significantly longer operative time.

Postoperative analgesic requirements seem to be lower in the study group, although using the number of injections rather than actual total analgesic dose may not be the most precise way to quantify postoperative pain. Other studies have suggested that pain is decreased after laparoscopic surgery when compared with open colorectal surgery. Yet, prospective and randomized studies are necessary to demonstrate that this is true. Prolonged abdominal distention due to the pneumoperitoneum


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