A comparison of hand-assisted laparoscopic surgery and conventional laparoscopic surgery in rectal cancer: a propensity score analysis

Pyo, Dae Hee; Huh, Jung Wook; Park, Yoon Ah; Cho, Yong Beom; Yun, Seong Hyeon; Kim, Hee Cheol; Lee, Woo Yong; Chun, Ho-Kyung

doi:10.1007/s00464-015-4496-z

Cited by 12 publications

(6 citation statements)

References 15 publications

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“…There are no differences of short-term outcomes (return of bowel function, tolerance of diet, length of stay, postoperative pain scores) between hand-assisted and conventional laparoscopic colectomy [5]. HALS showed no difference in oncological outcomes comparing to conventional open surgical approach in colonic or rectal cancer [11][12][13]. This paper aims to update our previously published views and present updated data and review short-term results of all HALS cases performed in our centre for invasive cancers of left colon and rectum [14].…”

Section: Introductionmentioning

confidence: 85%

“…На сегодняшний день известно, что между HALS и обычной лапароскопической операцией не существует различий во времени восстановления функции кишечника, возобновления приёма пищи, длительности койко-дня и послеоперационного болевого синдрома [5]. Кроме того, операции с ручной ассистенцией при раке толстой кишки не имеют отличий в онкологических результатах лечения по сравнению с открытым хирургическим подходом [11][12][13]. Настоящая статья призвана освежить наши ранее опубликованные взгляды и представить обновленные данные, рассмотрев непосредственные результаты лечения всех пациентов с инвазивным раком левой половины толстой кишки и прямой кишки, которым в нашем центре выполнялись лапароскопические резекции с ручной ассистенцией [14].…”

Section: Introductionunclassified

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Hand-Assisted Laparoscopic Surgery for the Cancer of the Left Colon and Rectum - An Ideal Option of Minimally Invasive Surgery? Single Centre Experience With 459 Cases

et al. 2017

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BACKGROUND/OBJECTIVE. Hand-assisted laparoscopic surgery (HALS) has been introduced into clinical practice almost three decades ago, very soon after the introduction of conventional laparoscopic surgery. It combines the advantages of both laparoscopic (minimally invasive) and open surgery. Despite a good piece of data in the medical literature, the clear place of this kind of laparoscopic surgery today is not easy to delineate. Our study aimed to review single centre experience in treating patients with left colon and rectal cancers using HALS. METHODS. This study was a retrospective analysis of prospectively collected data of 459 patients undergoing hand assisted laparoscopic colorectal surgery for left colon and rectal cancer, in a single tertiary care institution, National Cancer Institute, from January 1, 2006, to December 31, 2016. All consented patient with confirmed invasive cancer of left colon and rectum undergoing HALS were included in the analysis. RESULTS. The patients’ mean age was 64.14±9.75 years. Female and male ratio was similar: 232 (50,5 %) versus 227 (49,5 %). The mean length of postoperative hospital stay was 6.7 (from 2 to 34) days. There were 5 (1,1 %) conversions to open surgery. Histological examination revealed mean lymph node harvest to be 15 ± 12, ranging from 8 to 90. Stage I, II and III cancer was similar in distribution accounting for 133 (28,9%), 139 (30,3 %), 151 (32,9 %) patients respectively and 36 (7,8 %)patients with stage IV. 244 (53,2) of patients underwent surgery for the cancer of the left colon (sigmoid colectomy or left hemicolectomy), and 215 (46,8 %) patients underwent surgery for rectal cancer. Postoperative complications occurred in 28 (6.1 %) patients, eight of them (1,7 %) needed reintervention (laparotomy) because of anastomotic insufficiency and intraabdominal abscesses. Two (0,4 %) patients died during 30 day postoperative period. CONCLUSION. In our experience, HALS was very reliable andfeasible minimally invasive surgical technique for the cancers of left colon and rectum, related with short learning curve and excellent oncological clearance, short operating time and low number of postoperative complications. It may be used as a standard approachfor this type of pathology, or as a safe bridge from open to conventional laparoscopic surgery.

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Section: Introductionmentioning

confidence: 85%

Section: Introductionunclassified

Hand-Assisted Laparoscopic Surgery for the Cancer of the Left Colon and Rectum - An Ideal Option of Minimally Invasive Surgery? Single Centre Experience With 459 Cases

et al. 2017

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“…Four additional trocars were then inserted in each of the four quadrants of the abdomen under laparoscopic visualization. After initial exploration, similar standard techniques were used in both procedures [13][14][15][16]. The postoperative management and discharge criteria were similar among surgeons because they shared a common clinical protocol (CP) at the institution.…”

Section: Methodsmentioning

confidence: 99%

The impact of obesity on the outcomes of laparoscopic colectomy: An observational study

Choi¹,

Huh²,

Oh³

et al. 2016

Korean J Clin Oncol

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The impact of obesity on the surgical outcomes of Asian patients undergoing laparoscopic colon surgery is not clear. The purpose was to evaluate the outcome of laparoscopic surgery in obese Asian patients with colon cancer. Methods: We retrospectively reviewed the prospectively collected data of 1,740 consecutive patients who underwent laparoscopic surgery for colon cancer between January 2008 and December 2010. Patients were classified according to the categories proposed by the International Obesity Task Force, Non-obese (body mass index [BMI]<25.0 kg/m 2), Obese-I (BMI, 25.0-29.9 kg/m 2), and Obese-II (BMI≥30 kg/m 2). Surgical outcomes, including open conversion, operative time, and postoperative hospital stay, were compared in the Non-obese, Obese-I, and Obese-II patients. Results: Of the 1,192 patients in the study, 812 (68.1%), 360 (30.2%), and 20 (1.7%), were classified as Non-obese, Obese-I, and Obese-II, respectively. The Obese-II group had higher conversion rates (10.0% vs. 3.6% and 1.6%, P=0.008) and, longer operative times (180.35 vs. 162.54 and 147.84 minutes, P<0.001) than the Obese-I and Non-obese group. However, the other postoperative outcomes were not significantly different. The overall survival and disease-free survival were not significantly different between groups (P=0.952). Multivariate analysis showed that the independent risk factor for conversion were BMI, total operative time, previous operative history, and cancer perforation. Conclusion: The outcomes of laparoscopic colon surgery in obese patients are similar to those of non-obese patients, offering all the benefits of a minimally invasive approach. However, the conversion rate was higher in obese patients. It is therefore very important for surgeons to be aware of these risks during laparoscopic colon surgery in obese patients.

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“…The main findings of studies comparing open, straight laparoscopic, and hand-assisted low anterior resection (HALAR) can be summarized as follows [105][106][107][108][109][110][111][112][113][114][115]:…”

Section: Hand-assisted Rectal Cancer Surgerymentioning

confidence: 99%

Colorectal Cancer: Minimally Invasive Surgery

Spinelli

2021

The ASCRS Textbook of Colon and Rectal Surgery

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Concepts• Minimally invasive colorectal surgery has evolved considerably, especially in the last 30 years. • Potential advantages of a minimally invasive approach go beyond smaller incision size: reduced interference with body homeostasis has positive impacts both in the clinical and social spheres. • MIS for colon cancer has been well accepted for many years, but the application of MIS techniques to rectal cancer is more controversial. • Techniques utilized to perform proctectomy are not as mature as those to perform colectomy, and potential advantages/risks of minimally invasive proctectomy versus open proctectomy are still debated.

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A comparison of hand-assisted laparoscopic surgery and conventional laparoscopic surgery in rectal cancer: a propensity score analysis

Abstract: HALS is considered a safe and feasible approach for rectal cancer treatment that enables the preservation of the advantages of conventional laparoscopic surgery.

Cited by 12 publications

References 15 publications

Hand-Assisted Laparoscopic Surgery for the Cancer of the Left Colon and Rectum - An Ideal Option of Minimally Invasive Surgery? Single Centre Experience With 459 Cases

Hand-Assisted Laparoscopic Surgery for the Cancer of the Left Colon and Rectum - An Ideal Option of Minimally Invasive Surgery? Single Centre Experience With 459 Cases

The impact of obesity on the outcomes of laparoscopic colectomy: An observational study

Colorectal Cancer: Minimally Invasive Surgery

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