Laparoscopic Colorectal Surgery Produces Better Outcomes for High Risk Cancer Patients Compared to Open Surgery

Hemandas, Anil; Abdelrahman, Tarig; Flashman, Karen; Skull, Angela; Senapati, Asha; O’Leary, D; Parvaiz, Amjad

doi:10.1097/sla.0b013e3181e45b66

Cited by 92 publications

(78 citation statements)

References 47 publications

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“…Despite these limitations, the current observations indicate that SLS has equivalent short-term surgical outcomes to MLS and is oncologically feasible in elderly patients, consistently with the results of previous reports in the general population (16)(17)(18)(19)(20)(21)(22)(23). Thus, we believe that these results justify the use of SLS in the routine treatment of elderly patients with colon cancer.…”

Section: Discussionsupporting

confidence: 80%

“…Several studies have reported that MLS demonstrates oncological results and surgical outcomes comparable to that of open surgery (16)(17)(18)(19)(20)(21)(22)(23). However, in the elderly, although MLS is reported to be non-inferior to the open procedure and may be an acceptable alternative in elderly patients with colorectal cancer (24), no study has investigated the feasibility of SLS in elderly patients with colon cancer, with the exception of one small study (10).…”

Section: Introductionmentioning

confidence: 99%

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Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

et al. 2016

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Abstract. The safety of single-incision laparoscopic surgery (SLS) in elderly patients with colorectal cancer has not been established. The aim of the current study was to compare the outcomes of SLS and multi-port laparoscopic surgery (MLS) and to assess the feasibility of SLS in colorectal cancer patients aged ≥70 years. A retrospective case-control study of colon cancer patients undergoing elective surgical intervention between 2011 and 2014 was conducted. A total of 129 patients with colon cancer underwent surgery and were included in the analysis. Data regarding patient demographics, surgical variables, oncological outcomes and short-term outcomes were evaluated for statistical significance to compare MLS (n=79) and SLS (n=50) in colon cancer patients. No significant differences were observed in patient characteristics. No case required re-admission within 30 days post surgery. The mean surgery times were similar for the MLS and SLS groups when cases with left and right hemicolectomies were combined (207.7 and 215.9 min, respectively; P= 0.47). In addition, overall perioperative outcomes, including blood loss, number of lymph nodes harvested, size of the surgical margin and complications, were similar between these groups. Thus, we suggest that SLS can be performed safely in elderly patients with colon cancer.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

et al. 2016

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“…Clips or vascular staplers were used for mobilization, isolation, and ligation of the main vessels from the medial to the lateral aspect of colorectal tissues (Mehmood et al, 2011). As previously described, total mesorectal excision was performed using monopolar diathermy for rectal cancers (Heald et al, 1982;Hemandas et al, 2010). A wound protector was used to protect the sample extraction site, and anastomoses were performed intracorporeally.…”

Section: Surgical Techniquementioning

confidence: 99%

“…As previously described (Hemandas et al, 2010), open colectomy was performed using a midline incision, while laparoscopy was performed using a 5-port technique and a transverse incision of approximately 5 cm for extraction of the specimen. Patients were placed in the improved lithotomy position (Sachs and Peters, 1999) with the surgeon standing on the right side of the patient.…”

Section: Surgical Techniquementioning

confidence: 99%

No difference of complete or incomplete left-sided malignant colonic obstruction on both short- and long-term outcomes

Liu

Huang

et al. 2014

Genet. Mol. Res.

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ABSTRACT. The impact of complete and incomplete colonic obstruction on the short-and long-term outcomes of malignant colorectal cancer has not yet been elucidated. The aim of this study was to investigate whether there was a difference in the impacts of the 2 types of obstruction on the short-and long-term outcomes of colorectal resection. This study included 224 colorectal cancer patients (162 patients with incomplete obstruction and 62 with complete obstruction) with left-sided malignant colonic obstruction who underwent surgical therapy between February 2007 and September 2012. The short-and long-term outcomes of surgical therapy were analyzed. No significant difference was found between the 2 groups with regard to short-term outcomes such as the curative resection rate (80.86 vs 70.97%, P = 0.109), hospital stay time (24.20 ± 16.01 vs 24.19 ± 12.06, P = 0.999), and the overall and respective complications (32.72 vs 46.77%, P = 0.051). Furthermore, no significant difference was found between the 2 groups with regard to long-term outcomes including the 1-, 3-, and 5-year survival rates (P = 0.089), recurrence rates (P = 0.711), and recurrence-free survival rates (P = 0.440). The 2 types of obstruction, i.e., complete and incomplete left-sided malignant colonic obstruction, had no impact on the short-and long-term outcomes of colorectal resection. Similar therapeutic methods can be used for treating both types of obstruction.

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“…In another study [6], while The United States Association of Colorectal Surgeons did not encourage laparoscopy, in other countries this procedure is found safe and comparable with open surgery regarding relapses and 3 years survival. Laparoscopy was found superior in high risk patients (in a study over 424 cases [7]) and also in reducing postoperative blood loss, low incidence of intestinal obstruction by adhesions and reduced long term morbidity compared with classic surgery in 1544 cases, without significant changes in local or distant relapses [8].…”

Section: Introductionmentioning

confidence: 99%

European Colorectal Cancer Management: Implemented as it is or Adapted to our National Specificity

Dobre

Hintea

Azamfirei

2015

Acta Medica Marisiensis

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Objective: We attempt to evaluate how the European treatment guides are implemented in a clinic hospital in Targu Mures and if those rules could be adopted as they are or must be adapted to our national specificity. Methods: For a number of 441 patients included in the study, the electronic prospectively maintained archive of 3rd Surgery was interrogated for: age, preoperative colonoscopy, postoperative colonoscopies, chemo-radiotherapy enrollment, stage of the disease, type of surgery. Local and regional relapses were assessed and their incidence was related to type of surgery. Survival analysis was done in a simplified manner and differentiated for age below and above 75 years. Results: Patient's age distribution revealed a deviation to the right compared with a normal distribution with a median off 64.76±11.47. Colonoscopy was done in only 65 cases, exclusive preoperatively. Chemoradiotherapy was administered in 168 cases, only 12 of them initiated preoperatively. The type of surgery performed was found positively correlate with the stage of the disease. The survival probability for the patients in this study showed a 50% survival rate at 1 year and only 2% at 5 years. Conclusions: Passive screening age in CRC should be decreased to 55 years. Stage 3 and 4 of disease for CRC are over 70% of cases, like 20 years ago. Survival rate in CRC is far lower than other studies. Integrated CRC management and European practical guides are still "in wishing" stage.

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Laparoscopic Colorectal Surgery Produces Better Outcomes for High Risk Cancer Patients Compared to Open Surgery

Abstract: Laparoscopic resection of colorectal cancer can achieve excellent results even in "high risk" patients and is associated with significant reductions in length of stay compared with open resection.

Cited by 92 publications

References 47 publications

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

Single-port versus multi-port laparoscopic surgery for colon cancer in elderly patients

No difference of complete or incomplete left-sided malignant colonic obstruction on both short- and long-term outcomes

European Colorectal Cancer Management: Implemented as it is or Adapted to our National Specificity

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