Clinical efficacy of laparoscopic surgery combined with colonoscopy procedure in the treatment of early colorectal tumor

Objective To analyze the colonoscopy-assisted laparoscopic surgery in the treatment of early colorectal tumor, and further elevate the application value of them in the treatment of early colorectal cancer. Methods From January, 2014 to May, 2017, a total of 31 early colorectal tumor patients were treated with colonoscopy-assisted laparoscopic surgery in our hospital. Locations of colorectal lesions were explored by colonoscopy. According to the rapid frozen pathological results, laparoscopic surgery was selected. Results All patients were treated with colonoscopy-assisted laparoscopic surgery successfully, with no conversion to laparotomy. Among 22 cases of preoperative diagnosis of stageⅠcolorectal cancer, there were 20 cases of intraoperative and postoperative diagnosis of stageⅠ (13 cases of T1N0M0, 7 cases of T2N0M0) and 2 cases of stageⅢ (T2N1M0). There were 9 cases of preoperative diagnosis of precancerous lesions, 2 of which were diagnosis of high grade intraepithelial neoplasia and 7 cases were diagnosis of high grade intraepithelial neoplasia with carcinogenesis.6 cases were under polypectomy at the same time, the rapid frozen pathological results proved to be a low level adenomatoid polyp during the operation, and no additional surgery was performed. All patients were examined by colonoscopy half a year after operation. After that, 1 time a year was reviewed, and tumor markers were monitored at the same time. All patients were followed up 6-42 months, with a median of 32 months.Most of the patients were alive without recurrence except one case died of cerebral infarction 2 years after operation. Conclusion Laparoscopy combined with colonoscopy in treatment of early colorectal tumor has advantages of both endoscopy, especially suitable for lesions with difficult location or complete resection, which can improve surgical accuracy and safety.