Laparoscopic Versus Open Surgery for Rectal Cancer: A Meta-Analysis

Aziz, Omer; Constantinides, Vasilis; Tekkis, Paris; Athanasiou, Thanos; Purkayastha, Sanjay; Paraskeva, Paraskevas; Darzi, Ara; Heriot, Alexander G.

doi:10.1245/aso.2006.05.045

Cited by 364 publications

(260 citation statements)

References 38 publications

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“…However, time to oral intake as a measure of recovery of gastrointestinal function is prone to bias, as surgeons with an interest in laparoscopic surgery are likely to feed their patients earlier than those who perform open surgery [46]. Regarding SILC, in 39 cases of multi-institutional studies reviewed [47], average time to flatus and bowel movement was 2.2 and 2.9 days, respectively, a finding also supported by a single other report [48] (postoperative day 2-3 of first flatus).…”

Section: Discussionmentioning

confidence: 99%

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Αποστόλου

Orfanos²,

Papalois

et al. 2015

Indian J Surg

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As surgeons became more adept with laparoscopic colon surgery, other less invasive procedures, such as singleincision laparoscopic right hemi-colectomy (SIL-RH), have been applied. The objective of this study was to evaluate the safety of SIL-RH as well as its intraoperative and postoperative outcomes for right-sided colon diseases. A detailed search in PubMed for citations that included SIL-RH from 2000 to 2014 revealed 21 studies fulfilling the criteria of the present review. A total of 684 patients were analyzed. Of the patients, 50.2 % were men. Mean patient age was 64.8 years. Of the patients, 36.1 % had already undergone an abdominal operation before the performance of SIL-RH, while 69 % of the patients underwent SIL-RH for colon cancer. Relatively low rates of overall morbidity (15 %) and mortality (0.75 %) were reported in the included studies. Mean length of postoperative hospital stay (LOS) was 5.5 days. Bowel motility return had a mean value of 2.8 days. Mean number of harvested lymph nodes (LN) was 19.2 LN. All resection margins were tumorfree. SIL-RH was a safe alternative to multiport laparoscopic right hemi-colectomy (ML-RH) in terms of morbidity and mortality, postoperative gastrointestinal function recovery, LOS, as well as oncological radicalness.

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Section: Discussionmentioning

confidence: 99%

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Αποστόλου

Orfanos²,

Papalois

et al. 2015

Indian J Surg

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“…In 2013, a RCT (JCOG0404 55) ) with a large co- hort (529 for LAC, 528 for OC, conversion rate 5.4%), was completed for patients with Stage II and III colon cancer at 30 tertiary centers in Japan. In an interim report, LAC showed impressive shortterm outcomes and similar long -term oncological outcomes, compared to OC.…”

Section: Long -Term Outcomes (Table 2)mentioning

confidence: 99%

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

Otani

Isohata

Kumamoto

et al. 2016

FJMS

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During the 1990s, laparoscopic resection was established as a treatment for gastrointestinal malignant tumors. A number of randomized controlled trials comparing laparoscopic -assisted colorectal surgery with conventional open colorectal surgery for colon cancer have been conducted. These trials have shown short -term benefits, and the vast majority demonstrated no significant difference in long -term outcomes. Laparoscopic -assisted colorectal surgery is widely performed for the treatment of colon cancer, whereas laparoscopic -assisted colorectal surgery for rectal cancer is less commonly performed. In recent years, there have been an increasing number of reports of laparoscopic -assisted colorectal surgery for rectal cancer, where improving short -term outcomes was shown, but no definitive effect on long -term survival has been shown to date. Randomized controlled trials focusing on long -term survival are currently ongoing.

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“…This minimally invasive technique offers many benefits for the patients as less postoperative pain, better cosmetics results, and shorter periods of hospitalization [1][2][3]. Laparoscopic surgery, however, demands additional psychomotor abilities and skills different from those in conventional open surgery [4,5].…”

Section: Abstract Laparoscopic Surgery • Surgical Training • Objectivmentioning

confidence: 99%

Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons

et al. 2014

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Background The aim of this study is to present face, content, and constructs validity of the endoscopic orthogonal video system (EndoViS) training system and determines its efficiency as a training and objective assessment tool of the surgeons' psychomotor skills. Methods Thirty-five surgeons and medical students participated in this study: 11 medical students, 19 residents, and 5 experts. All participants performed four basic skill tasks using conventional laparoscopic instruments and EndoViS training system. Subsequently, participants filled out a questionnaire regarding the design, realism, overall functionality, and its capabilities to train hand-eye coordination and depth perception, rated on a 5-point Likert scale. Motion data of the instruments were obtained by means of two webcams built into a laparoscopic physical trainer. To identify the surgical instruments in the images, colored markers were placed in each instrument. Thirteen motion-related metrics were used to assess laparoscopic performance of the participants. Statistical analysis of Flores • performance was made between novice, intermediate, and expert groups. Internal consistency of all metrics was analyzed with Cronbach's a test.Results Overall scores about features of the EndoViS system were positives. Participants agreed with the usefulness of tasks and the training capacities of EndoViS system (score >4). Results presented significant differences in the execution of three skill tasks performed by participants. Seven metrics showed construct validity for assessment of performance with high consistency levels. Conclusions EndoViS training system has been successfully validated. Results showed that EndoViS was able to differentiate between participants of varying laparoscopic experience. This simulator is a useful and effective tool to objectively assess laparoscopic psychomotor skills of the surgeons. Keywords Laparoscopic surgery • Surgical training • Objective assessment • Motion metrics • Validation • Endoscopic orthogonal video system (EndoViS)Laparoscopic surgery has become an important technique within several surgical specialties, such as general surgery, gynecology, and urology. This minimally invasive technique offers many benefits for the patients as less postoperative pain, better cosmetics results, and shorter periods of hospitalization [1][2][3]. Laparoscopic surgery, however, demands additional psychomotor abilities and skills different from those in conventional open surgery [4,5].Traditionally, surgical residents acquire minimally invasive skills based on the classic apprenticeship model with hands-on training in the operation room [6,7]. This training method is not efficient, prolongs the learning curve of surgeons, and represents a potential risk to patient safety. Due to concerns for medical safety, it is essential the development of training methods for safe practice of laparoscopic surgery outside of the operating theater with the additional assessment of the surgical skills of surgeons.Currently, laparoscopic sur...

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Laparoscopic Versus Open Surgery for Rectal Cancer: A Meta-Analysis

Cited by 364 publications

References 38 publications

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

Single-Incision Laparoscopic Right Hemi-Colectomy: a Systematic Review

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

Face, content, and construct validity of the EndoViS training system for objective assessment of psychomotor skills of laparoscopic surgeons

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