Elective laparoscopic-assisted sigmoid resection for diverticular disease

Eijsbouts, Q. A. J.; Cuesta, Miguel A.; Brauw, L. M. de; Sietses, C.

doi:10.1007/s004649900442

Cited by 70 publications

(38 citation statements)

References 8 publications

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“…Other groups have also largely forgone the use of foreign material for rectopexy with colonic resection on account of the danger of infection and resulting severe complications [18,37]. That effective rectopexy is possible with suture fixation alone has been shown in a number of studies [9,13,33]. The technique of laparoscopic rectopexy with and without resection of the colon corresponds largely to that employed in open surgery and, in the hands of an experienced laparoscopic surgeon, can be applied with safety [10,24,43].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of rectal prolapse: experience gained in a prospective multicenter study

Rose¹,

Schneider²,

Scheidbach³

et al. 2002

Langenbeck's Archives of Surgery

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The techniques of conventional prolapse surgery can readily be translated to the laparoscopic modality, since oncological criteria do not have to be considered. The usually elderly patients in this group benefit to a particular degree from the known advantages associated with reduced surgical trauma. Perioperative morbidity is determined largely by the surgeon's experience. We therefore believe that rectal prolapse is a suitable indication for the minimally invasive modality in the hands of trained surgeons.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of rectal prolapse: experience gained in a prospective multicenter study

Rose¹,

Schneider²,

Scheidbach³

et al. 2002

Langenbeck's Archives of Surgery

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“…Results thus far have been favorable, and this type of advanced endometriosis can be treated by laparoscopy in nearly all patients (unpublished data). These benign conditions, although potentially associated with moderate to severe inflammatory changes, have been safe and feasible in most cases [27][28][29][30][31][32][33]. They also do not require wide mesenteric excision, nor do they carry the risks of port-site metastasis; thus they have been less controversial than laparoscopic resections for malignancy.…”

Section: Laparoscopic Intestinal Resection For Benign Diseasementioning

confidence: 99%

Laparoscopic Surgery of the Colon and Rectum

1999

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The use of laparoscopic techniques in benign colorectal surgery has expanded over the past several years, but controversy continues to surround the use of laparoscopic resection in cases of colorectal carcinoma. Diagnostic laparoscopy, the creation of stomas, and limited resections are becoming reasonable indications for benign diseases. In cases of malignancy, resection through a conventional incision or a laparoscope must adhere to the same defined surgical oncologic principles. Current randomized trials comparing open resection to laparoscopic resection should address these concerns. Port-site recurrence remains a leading concern regarding the widespread acceptance of laparoscopic resection for colorectal carcinoma. This article focuses on the applications of laparoscopic colorectal surgery for malignant diseases. Further research in this area combined with advances in laparoscopic technology will be critical to the future successful application of laparoscopic surgery to colorectal carcinoma.

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“…This results in a prolonged learning curve [8, 9, 10, 11, 12]. Meanwhile, laparoscopic colorectal surgery may offer several advantages to patients and can be carried out with low morbidity in both benign diseases and colorectal cancer [13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32]. However, its final role is still unclear as crucial issues such as the definite role of laparoscopy in the treatment of colorectal malignancy are still under discussion [33, 34, 35, 36, 37].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Colorectal Surgery:A Five-Year Experience

Bruch

Schiedeck²,

Schwandner³

1999

Dig Surg

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Objective: The aim of this study was to assess the feasibility and outcome of 300 laparoscopic colorectal procedures performed within 5 years for both benign and malignant disorders. The specific purpose was to identify the impact of the learning curve on reducing morbidity and on improving the outcome of laparoscopic colorectal surgery. Patients and Methods: All cases were divided into 3 groups: the first 100, the second 100 and the third 100 procedures were analyzed. Statistical analysis was performed by Student’s t test and χ² test. Results: The laparoscopic procedure had to be converted to open surgery in 22 cases (mean conversion rate 7.3%). Thus, a total of 278 procedures could be performed laparoscopically. The mean major complication rate was 8.6%, minor complications occurred in 9.7%. The overall morbidity rate was 18.3%. In 44 cases, laparoscopic resections were performed for the cure of colorectal malignancy. The mean lymph node harvest was 12.8 nodes, no port-site recurrence was documented at a mean follow-up of 22 months. Analyzing our 5-year experience, the incidence of conversion showed a decline from 8.0% (1st and 2nd 100) to 6.0% in the last 100 procedures (p > 0.05). The major complication rate was significantly decreased from 15 to 6.0% (1st vs. 2nd 100) and was 5.0% in the 3rd group. The minor complication rate, overall morbidity rate and laparotomy rate have also been reduced (p > 0.05). The duration of surgery was shortened from 251.4 to 213.5 min (1st vs. 2nd 100, p < 0.05) and was 196.9 min in the last 100 procedures. Postoperative hospital stay was decreased from 16.3 to 14.3 days (1st 100 vs. 2nd 100, p > 0.05) and could be shortened to 11.2 days (2nd vs. 3rd 100, p < 0.05). Conclusion: With increasing experience, laparoscopic colorectal surgery can be performed with reduced morbidity and improved outcome. To evaluate the role of laparoscopic colorectal procedures, particularly for the cure of malignancy, prospective randomized trials are necessary.

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Elective laparoscopic-assisted sigmoid resection for diverticular disease

Abstract: Because of the complexity of this inflammatory process, choice of either an assisted or a more invasive laparoscopic facilitated approach is necessary. The decision is based on the technical difficulty as determined by data collected both preoperatively and during laparoscopy.

Cited by 70 publications

References 8 publications

Laparoscopic treatment of rectal prolapse: experience gained in a prospective multicenter study

Laparoscopic treatment of rectal prolapse: experience gained in a prospective multicenter study

Laparoscopic Surgery of the Colon and Rectum

Laparoscopic Colorectal Surgery:A Five-Year Experience

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