Are there differences between right and left colectomies when performed by laparoscopy?

Turrado-Rodríguez, Víctor; Soler, Eduard Targarona; Rodríguez, J; Ponz, Carmen Balaguè; Casanovas, Pilar Hernández; Martínez, Carmen Rodríguez; Folch, Manel Trías

doi:10.1007/s00464-015-4345-0

Cited by 13 publications

(17 citation statements)

References 20 publications

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“…Unfortunately, patients with a history of recurrent or complicated diverticulitis may have loss of tissue planes as a result of acute or chronic inflammatory processes, especially in the pelvis or along the ureter and gonadal vessels. Therefore, laparoscopic colectomy for diverticular disease is more technically demanding and has a higher rate of intraoperative complications than left colectomy for cancer 7 . Moreover, conversion rates to the open approaches of up to 21% have been reported (ranging from 2.2% to 21%) 7,8,20 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, laparoscopic colectomy for diverticular disease is more technically demanding and has a higher rate of intraoperative complications than left colectomy for cancer 7 . Moreover, conversion rates to the open approaches of up to 21% have been reported (ranging from 2.2% to 21%) 7,8,20 . Conversion to laparotomy has been reported to be even higher in patients with complicated fistulizing disease, with figures of up to 34.7%, 21 with higher conversion rates being associated with higher complication rates 22 and financial healthcare burden 10 .…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, laparoscopic colectomy for diverticular disease is technically demanding and has a higher rate of intraoperative complications than left colectomy for cancer 7 . Moreover, conversion rates to open approaches of up to 21% have been reported 7,8 . Higher postoperative morbidity and healthcare costs are the two principal consequences associated with the conversion from minimally invasive to open sigmoidectomy for diverticular disease 9,10 …”

Section: Introductionmentioning

confidence: 99%

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Robotic elective colectomy for diverticular disease: short‐term outcomes of 80 patients

Formisano

Giuliani

Salaj

et al. 2020

Robotics Computer Surgery

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Background This study aimed to evaluate the impact of the robotic approach on the minimally invasive elective treatment of diverticular disease. Methods Data from patients who underwent elective robotic colectomy for diverticular disease from January 2015 to February 2020 were prospectively collected and retrospectively analysed. Intraoperative and 30‐day postoperative outcomes were the variables assessed. Results A total of 80 patients (71% with prior complicated diverticulitis) met the inclusion criteria. Mean operative time was 241 min, one intraoperative complication (1.2%) was observed, the conversion rate was 2.5%. Mean hospital stay was 6.4 days and overall 30‐day complication rate was 22.5%. Fourteen patients (17.5%) had minor complications, while major postoperative complications occurred in four patients (5%). Anastomotic leak rate was 3.9% and the 30‐day readmission rate was 3.7%. Conclusions Robotic colectomy for diverticular disease has proven to be feasible and safe, with low intraoperative complications, conversion, and anastomotic leak rates.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Robotic elective colectomy for diverticular disease: short‐term outcomes of 80 patients

Formisano

Giuliani

Salaj

et al. 2020

Robotics Computer Surgery

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“…As a result, the type of surgery was not associated with POI ( P = 0.242). Although one retrospective study suggested that right-sided laparoscopic colectomy is associated with a four-fold higher risk of POI than a left-sided laparoscopic colectomy [ 18 ], another study failed to demonstrate a relationship between the risk of POI and the anatomical location of the surgery [ 19 ]. Thus, considering our results together, the impact of the anatomical location of the surgery on the risk of POI may not be substantial.…”

Section: Discussionmentioning

confidence: 99%

A retrospective analysis on the relationship between intraoperative hypothermia and postoperative ileus after laparoscopic colorectal surgery

Choi

Kim

et al. 2018

PLoS ONE

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Postoperative ileus (POI) is an important factor prolonging the length of hospital stay following colorectal surgery. We retrospectively explored whether there is a clinically relevant association between intraoperative hypothermia and POI in patients who underwent laparoscopic colorectal surgery for malignancy within the setting of an enhanced recovery after surgery (ERAS) program between April 2016 and January 2017 at our institution. In total, 637 patients were analyzed, of whom 122 (19.2%) developed clinically and radiologically diagnosed POI. Overall, 530 (83.2%) patients experienced intraoperative hypothermia. Although the mean lowest core temperature was lower in patients with POI than those without POI (35.3 ± 0.5°C vs. 35.5 ± 0.5°C, P = 0.004), the independence of intraoperative hypothermia was not confirmed based on multivariate logistic regression analysis. In addition to three variables (high age-adjusted Charlson comorbidity index score, long duration of surgery, high maximum pain score during the first 3 days postoperatively), cumulative dose of rescue opioids used during the first 3 days postoperatively was identified as an independent risk factor of POI (odds ratio = 1.027 for each 1-morphine equivalent [mg] increase, 95% confidence interval = 1.014–1.040, P <0.001). Patients with hypothermia showed significant delays in both progression to a soft diet and discharge from hospital. In conclusion, intraoperative hypothermia was not independently associated with POI within an ERAS pathway, in which items other than thermal measures might offset its negative impact on POI. However, as it was associated with delayed discharge from the hospital, intraoperative maintenance of normothermia is still needed.

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“…Several studies have discussed the differences between right and left colectomies and have reported inconsistent results for short-term complications. Some studies [ 24 , 25 ] concluded that right colectomies were associated with better outcomes, whereas others [ 26 ] reported that left colectomies were superior. Another study [ 27 ] found no difference in the complication rates when right and left colectomies were compared.…”

Section: Discussionmentioning

confidence: 99%

Procedural difficulty differences according to tumor location do not compromise the clinical outcome of laparoscopic complete mesocolic excision for colon cancer: a retrospective analysis

et al. 2017

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Laparoscopic colectomy procedures and their corresponding difficulty levels may vary depending on the tumor location within the colon, and a laparoscopic complete mesocolic excision (CME) with central vascular ligation (CVL) would require more proficiency than a conventional laparoscopic colectomy. We aimed to report our laparoscopic CME with CVL data and to investigate the clinical outcome differences of laparoscopic CME with CVL by various tumor sub-site locations. Prospectively collected clinical data of consecutive patients who received laparoscopic colectomy for primary colon cancer between April 1995 and December 2010 from single surgeon were retrospectively reviewed. All of the included surgery was performed on the basis of CME with CVL principle with no-touch isolation technique. Data were analyzed and compared among three groups; patients who received right or extended right hemicolectomy (group A, n = 142), transverse colectomy or left or extended left hemicolectomy (group B, n = 59), and sigmoidectomy or anterior resection (group C, n = 210). Female patients were more common in group A (53.5% vs. 37.3% vs. 39.5%, p = 0.020). Other baseline characteristics were comparable. Operative time was shorter in group C than the other groups (309.0 ± 74.7 vs. 324.3 ± 89.1 vs. 280.1 ± 93.1 min, p = 0.000). There was no significant difference among groups in perioperative complication and patient recovery. Five-year overall survival, disease-free survival and local recurrence rate showed no difference for a median follow up period of 73 (1–120) months. In conclusion, laparoscopic tumor-specific CME and CVL for colon cancer can be performed with comparable short- and long-term outcomes regardless of tumor sub-site location except for the operative time.

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Are there differences between right and left colectomies when performed by laparoscopy?

Cited by 13 publications

References 20 publications

Robotic elective colectomy for diverticular disease: short‐term outcomes of 80 patients

Robotic elective colectomy for diverticular disease: short‐term outcomes of 80 patients

A retrospective analysis on the relationship between intraoperative hypothermia and postoperative ileus after laparoscopic colorectal surgery

Procedural difficulty differences according to tumor location do not compromise the clinical outcome of laparoscopic complete mesocolic excision for colon cancer: a retrospective analysis

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