Quality of surgery for rectal carcinoma: comparison between open and laparoscopic approaches

Gouvas, Nikolaos; Tsiaoussis, John; Pechlivanides, George; Tzortzinis, Anastasios; Dervenis, Christos; Avgerinos, Costas; Xynos, Evaghelos

doi:10.1016/j.amjsurg.2008.10.020

Cited by 37 publications

(22 citation statements)

References 37 publications

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“…By 2010, the data from 13 We excluded patients who underwent two or more types of gastrectomy, colectomy, or anterior resection during hospitalization. We also excluded patients with a missing or unspecified Barthel index (BI) at admission and discharge.…”

Section: Methods Databasementioning

confidence: 99%

“…Therefore, their treatment should be less invasive so that they may maintain the same functional status as that before admission and prevent impaired health-related quality of life (HRQOL) [2,3]. Laparoscopic abdominal intestinal surgery (LS) has been a popular technological innovation, and many studies on its shortand long-term outcomes and safety have been performed [4][5][6][7][8][9][10][11][12][13][14][15][16]. LS has the advantage of earlier functional recovery, including resumption of oral intake, compared with open surgery (OS) [5,11,12,[14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Comparative study of functional outcomes of three laparoscopic intestinal surgical procedures

Kuwabara

Matsuda

Fushimi

et al. 2013

Health Policy and Technology

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Section: Methods Databasementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative study of functional outcomes of three laparoscopic intestinal surgical procedures

Kuwabara

Matsuda

Fushimi

et al. 2013

Health Policy and Technology

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“…In our study, we observed that using a 30-degree laparoscope, the pelvic cavity is much better visible than using open surgery. In recent studies, laparoscopy has offered a macroscopically more complete specimen after TME for rectal cancer than the open approach due to the superior view of the pelvis [28]. The most important technical difficulty in obese patients is the application of an endoscopic linear stapler for distal transection.…”

Section: Discussionmentioning

confidence: 99%

Impact of Increased Body Mass Index on Laparoscopic Surgery for Rectal Cancer

et al. 2011

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Background: Laparoscopy was initially considered to be a risky procedure for rectal cancer patients, especially patients with an increased body weight. The literature is scarce regarding the effects of obesity on laparoscopic rectal surgery. The aim of the current study was to analyze the effect of an increased body mass index (BMI) on outcome of laparoscopic surgery for rectal cancer. Methods: Patients who underwent laparoscopic rectal resection were allocated to one of three groups according to their BMI: normal weight (BMI < 25), overweight (25 ≤ BMI < 30) and obese (BMI ≧ 30). These three groups were compared with each other in terms of patient demographics, postoperative hospital stay, postoperative complications and histopathological data. Results: There were 100 patients operated on for rectal cancer. The median BMI of the patients was 27 (range 18.5–40) kg/m², and 43, 43 and 14 patients were classified as normal weight, overweight and obese, respectively. The conversion rate was 4.7% in the overweight group and 0% in the other groups. The proportion of complications and oncological outcomes between the groups showed no significant difference (p > 0.05). Conclusions: Apparently, increased BMI is not a contraindication for laparoscopic rectal surgery.

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“…In cases with a very low rectal carcinoma and favorable T-stage (I or II), an intersphincteric resection of the rectum and a handsewn coloanal anastomosis were offered. The laparoscopic approach has been previously described in detail [13,14,16]. Conversion of a laparoscopic procedure to open was defined as inability to complete the operation laparoscopically and an abdominal incision other than the initially planned was performed to complete the procedure.…”

Section: Surgical Interventionsmentioning

confidence: 99%

“…Since the beginning of the millen-Gouvas/Gogos-Pappas/Tsimogiannis/ Tsimoyiannis/Dervenis/Xynos nium, several studies have shown that the laparoscopic approach is feasible, safe and associated with faster recovery as compared to the open one [4][5][6][7][8][9][10][11]. Also, the laparoscopic approach is at least equivalent to open surgery in terms of short-term morbidity and medium-term oncological results [4,9,[12][13][14][15][16]. Although 'fast track' works with laparoscopy [17,18], there are only three studies that compare open to laparoscopic colorectal surgery, both within 'fast-track' protocols and report conflicting results [19][20][21].…”

Section: Introductionmentioning

confidence: 99%

Implementation of Fast-Track Protocols in Open and Laparoscopic Sphincter-Preserving Rectal Cancer Surgery: A Multicenter, Comparative, Prospective, Non-Randomized Study

et al. 2012

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Background: Data on the role of laparoscopy within an enhanced recovery protocol for rectal cancer patients is rather limited. The aim of the study was to investigate the role of laparoscopy within a ‘fast-track’ protocol in patients who underwent sphincter-preserving surgery for rectal cancer. Patients/Methods: 156 consecutive patients with low rectal cancer from three centers were assigned in four groups: the open fast track (OPEN-FT), the laparoscopic fast track (LAP-FT), the open (OPEN), and the laparoscopic (LAP). The fast-track protocol was applied in one center and traditional care in the other two. All patients underwent sphincter-preserving surgery and were followed-up for 30 days. Results: Overall morbidity was less in the fast-track groups (p = 0.007). On the other hand, no statistical significance could be identified in mortality, readmission or reoperations rates among the groups (p = 0.562, p = 0.896, p = 0.238). Fast-track patients required significantly less intramuscular opioids for postoperative analgesia (p < 0.001). Primary (p < 0.001) and total hospital stays (p < 0.001) were significantly shorter in the fast-track groups. Conclusion: The implementation of a fast-track protocol is feasible and safe in low rectal cancer patients. Laparoscopy seems to be a basic element of such protocol as it further enhances recovery and reduces morbidity.

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Quality of surgery for rectal carcinoma: comparison between open and laparoscopic approaches

Cited by 37 publications

References 37 publications

Comparative study of functional outcomes of three laparoscopic intestinal surgical procedures

Comparative study of functional outcomes of three laparoscopic intestinal surgical procedures

Impact of Increased Body Mass Index on Laparoscopic Surgery for Rectal Cancer

Implementation of Fast-Track Protocols in Open and Laparoscopic Sphincter-Preserving Rectal Cancer Surgery: A Multicenter, Comparative, Prospective, Non-Randomized Study

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