An evidence-based medicine approach to the laparoscopic treatment of colorectal cancer

Otani, Taisuke; Isohata, Noriyuki; Kumamoto, Kensuke; Endo, Shunsuke; Utano, Kenichi; Nemoto, Daiki; Aizawa, Masato; Lefor, Alan Kawarai; Togashi, Kazutomo

doi:10.5387/fms.2016-4

Cited by 4 publications

(4 citation statements)

References 60 publications

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“…During the operation, the inflammatory reaction was mild, the amount of bleeding and fluid loss was small, and the internal environment was relatively stable in laparotomy. Post-operative patients had mild pain response, rapid recovery, and significantly reduced exhaust time and total hospitalization time as compared with those after laparotomy ( 21 – 23 ). Moreover, the results of this study showed that the duration of abdominal distension, the time for bowel sounds to return to normal, the time for normal anal exhaust, and the time for normal food intake in the observation group were all lower than those in the control group.…”

Section: Discussionmentioning

confidence: 93%

Laparoscopic Radical Resection of Colorectal Cancer in the Treatment of Elderly Colorectal Cancer and Its Effect on Gastrointestinal Function

Liu

2022

Front. Surg.

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ObjectiveTo explore the efficacy and safety of laparoscopic radical resection of colorectal cancer in the elderly patients and its impact on gastrointestinal function.MethodsA total of 122 elderly patients with colorectal cancer admitted to our hospital from March 2020 to June 2021 were selected as the research subjects, and they were divided into the control group (n = 61) and the observation group (n = 61). The control group was treated with traditional laparotomy, and the observation group was treated with laparoscopic radical resection of colorectal cancer. The clinical data of operation time, incision length, intraoperative bleeding volume, and hospitalization time in the two groups were recorded. Serum motilin (MTL) and gastrin (GAS) levels were measured pre- and post-operatively. The duration of abdominal distension, the time for the abdominal sound to return to normal, the time for the anal exhaust to normal, and the time for normal food intake were recorded after operation. The patients were followed up for 6 months post-operatively, and the complications during follow-up were recorded.ResultsThe total response rate of the observation group (95.08%) was higher than that of the control group (81.97%) (P < 0.05). The operation time, incision length, intraoperative bleeding volume, and hospitalization time of the observation group were lower than those of the control group (P < 0.05). The duration of abdominal distension, the time for bowel sounds to return to normal, the time for the anus to exhaust gas to normal, and the normal eating time in the observation group were all lower than those in the control group (P < 0.05). After surgery, the levels of MTL and GAS in the two groups were lower than those before surgery, and those in the observation group were lower than those in the control group (P < 0.05). The total incidence of complications in the observation group (3.28%) was lower than that in the control group (13.12%) (P < 0.05).ConclusionLaparoscopic radical resection of colorectal cancer in the elderly patients has good effect, short operation time, less trauma, less blood loss during operation, short hospital stay, good recovery of gastrointestinal function, fewer complications, and high safety.

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Section: Discussionmentioning

confidence: 93%

Laparoscopic Radical Resection of Colorectal Cancer in the Treatment of Elderly Colorectal Cancer and Its Effect on Gastrointestinal Function

Liu

2022

Front. Surg.

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“…Various trials have shown that laparoscopic patients suffer less from postoperative pain and wound infection, leading to faster convalescence and a shorter hospital stay [16,[19][20][21][22][23]. This was confirmed by a meta-analysis from Schwenk et al [24] and a systematic review from Otani et al [25].…”

Section: Postoperative Morbidity and Mortalitymentioning

confidence: 85%

Laparoscopic surgery for colon cancer

et al. 2020

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Background To evaluate a new procedure in daily clinical practice, it might not be sufficient to rely exclusively on the findings of randomized clinical trials (RCTs). This is the first systematic review providing a synthesis of the most important RCTs and relevant retrospective cohort studies on short- and long-term outcomes of laparoscopic surgery in colon cancer patients. Materials and methods In a literature search, more than 1800 relevant publications on the topic were identified. Relevant RCTs and representative high-quality retrospective studies were selected based on the widely accepted Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. Finally, 9 RCTs and 14 retrospective cohort studies were included. Results Laparoscopic surgery for colon cancer is associated with a slightly longer duration of surgery, but a variety of studies show an association with a lower rate of postoperative complications and a shorter duration of hospital stay. Particularly in older patients with more frequent comorbidities, laparoscopy seems to contribute to decreasing postoperative mortality. Concerning long-term oncologic outcomes, the laparoscopic and open techniques were shown to be at least equivalent. Conclusion The findings of the existing relevant RCTs on laparoscopic surgery for colon cancer are mostly confirmed by representative retrospective cohort studies based on real-world data; therefore, its further implementation into clinical practice can be recommended.

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“…The number of harvested lymph nodes is shown in table (1). In nine patients, all harvested LNs were negative, whereas in 11 patients there were positive LNs infiltrated with malignancy.…”

Section: Pathological Characteristics Of the Tumormentioning

confidence: 99%

“…The treatment of rectal cancer has been thoroughly discussed in a considerable number of published studies [1][2][3][4] with a remarkable evolution in the technical aspects and the outcomes achieved. Regardless the operative technique employed; the ultimate goal is to accomplish complete clinical and pathological cure [5] together with satisfactory functional outcomes.…”

Section: Introductionmentioning

confidence: 99%

The Value of Laparoscopic Total Mesorectal Excision and Circumferential Resection Margin in the Treatment of Distal Rectal Cancer: Single Center Experience

Elbaz¹,

Omar²,

Elbanna³

et al. 2016

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Total mesorectal excision (TME) has emerged as a method for complete cure of rectal cancer with promising results. The present study aimed to evaluate the technical feasibility and the clinical and oncological outcomes of laparoscopic TME with abdominoperineal resection (APR) for distal rectal carcinoma. Twenty patients with distal rectal carcinoma were treated with laparoscopic APR and TME in the period of January 2012 to March 2015. Patients' demographics, clinical symptoms, operation time, complications, pathological characteristics of the rectal tumor, and the local and distant recurrence of the tumor were recorded and analyzed. The study included 11 (55%) female and 9 (45%) male of a mean age of 46.9 ± 10.8 years. The mean distance of the tumor from the anal verge was 3.35 ± 0.9 cm. The mean operation time was 182 ± 7 minutes. Adenocarcinoma accounted for 55% of cases, whereas mucinous adenocarcinoma was detected in 40% of patients, and signet ring carcinoma in 5%. The mean circumferential resection margin (CRM) was 4.6 ±3.5 mm. The mean duration of hospital stay was 9.21± 6.9 days. Perioperative complications were recorded in seven patients (35%). Five (25%) cases were converted to open surgery. The median follow-up duration was 18 months. Local recurrence was diagnosed in two (10%) cases. Laparoscopic TME is a technically feasible procedure, yet requires adequate training and sufficient knowledge of the anatomy of the pelvis. Although all patients underwent APR and 90% of them received neoadjuvant treatment; the local recurrence was still higher than other studies which can be attributed to the pathologic characters and the stage of the tumors.

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An evidence-based medicine approach to the laparoscopic treatment of colorectal cancer

Cited by 4 publications

References 60 publications

Laparoscopic Radical Resection of Colorectal Cancer in the Treatment of Elderly Colorectal Cancer and Its Effect on Gastrointestinal Function

Laparoscopic Radical Resection of Colorectal Cancer in the Treatment of Elderly Colorectal Cancer and Its Effect on Gastrointestinal Function

Laparoscopic surgery for colon cancer

The Value of Laparoscopic Total Mesorectal Excision and Circumferential Resection Margin in the Treatment of Distal Rectal Cancer: Single Center Experience

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