Postoperative complications of laparoscopic-assisted colectomy

Lacy, Antonio M.; García‐Valdecasas, Juan Carlos; Delgado, Salvadora; Grande, L; Fuster, J.; Tabet, J; Ramos, Carlos; Piqué, Josep M.; Cifuentes, Ana; Visa, Josep

doi:10.1007/s004649900311

Cited by 119 publications

(67 citation statements)

References 27 publications

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“…Nevertheless, laparoscopic colorectal surgery is still in a phase of critical appraisal as long as prospective randomized trials comparing laparoscopic and open surgery for colorectal diseases are still missing [43, 44]. Recently published data focussing on the learning curve have prompted us to analyze our 5-year experience with laparoscopic colorectal surgery [8, 9, 10, 11, 12, 41, 42, 43, 44, 45, 46]. …”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

Laparoscopic Colorectal Surgery:A Five-Year Experience

Bruch

Schiedeck²,

Schwandner³

1999

Dig Surg

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“…In total we had 27 procedures in this group. Majority of these procedures was for benign pathologies and only 1 patient got complicated bringing the complication rate to % which is far less than those reported by Viljakka M et al [22] and Lacy A M [23] . There were 25 urological procedures performed of which 2(8%) complications were reported.…”

Section: Discussionmentioning

confidence: 79%

A Study of the Correlation between Pre-Operative Risk Factors and Various Complications Occurring during and after Laparoscopic Procedures

Mitra¹

2017

JMSCR

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“…Jahr Patientenzahl Trokarkanalmetastasen n % Gellman et al [40] 1996 58 1 1,7 Franklin et al [41] 1996 191 0 Hoffman et al [42] 1996 130 1 0,8 Kwok et al [43] 1996 83 1 1,2 Vukasin et al [44] 1996 451 5 1,1 Fleshman et al [45] 1996 372 4 1,1 Lacy et al [46] 1997 106 0 Fielding et al [47] 1997 149 2 1,3 Larach et al [48] 1997 108 0 Croce et al [49] 1997 134 1 0,9 Khalili et al [50] 1998 80 0 Bouvet et al [51] 1998 91 0 Leung et al [52] 1999 154 1 0,6 Poulin et al [53] 1999 135 0 Pearlstone et al [54] 1999 93 0 Bo È hm et al [ …”

Section: Autorunclassified

Laparoskopische Chirurgie beim kolorektalen Karzinom: Sind die onkologischen Standards einzuhalten?

Bruch¹,

Schwandner²

2001

Visc Med

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Laparoscopic Surgery for Colorectal Cancer: Are Oncologic Standards Respected? Laparoscopic colorectal procedures offer several benefits postoperatively including reduction of pain, minimal impairment of pulmonary and gastrointestinal function, and improved reconvalescence. At present, laparoscopic resections for colorectal cancer are discussed controversially due to oncologic radicality, potential tumor dissemination, and the problem of port-site metastases. Oncologic standards of open surgery for colorectal cancer seem to be not compromised by the laparoscopic approach. Short-term results of both retrospective and prospective trials comparing open with laparoscopic surgery for colorectal cancer showed comparable oncologic outcome related to recurrence and survival. Despite extensive research efforts, neither the incidence of port-site recurrence nor its causes have been clarified definitely. However, according to the preliminary results of recently published studies, the problem of port-site metastases seems not be a specific problem of laparoscopic surgery, but rather an unfortunate sequel to the learning curve. Finally, as long-term results of prospective randomized trials are still missing, the fundamental issue whether laparoscopic resection for colorectal cancer is oncologically equivalent to open surgery cannot be answered definitely. Therefore, in the interim, laparoscopic curative resections for colorectal cancer are only to be offered within prospective randomized trials.

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Postoperative complications of laparoscopic-assisted colectomy

Abstract: We suggest that with the development of improved technical devices and more experience, the indications for laparoscopic colectomy should continue to expand. The low incidence of infectious complications suggests an important role for the laparoscopic approach to colorectal surgery.

Cited by 119 publications

References 27 publications

Laparoscopic Colorectal Surgery:A Five-Year Experience

Laparoscopic Colorectal Surgery:A Five-Year Experience

A Study of the Correlation between Pre-Operative Risk Factors and Various Complications Occurring during and after Laparoscopic Procedures

Laparoskopische Chirurgie beim kolorektalen Karzinom: Sind die onkologischen Standards einzuhalten?

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