Update: Laparoscopic Colon Surgery

Petropoulos, P; Chanson, Chr.; Kiesler, P; Nassiopoulos, Konstantinos

doi:10.1159/000172592

Cited by 3 publications

(2 citation statements)

References 4 publications

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“…To respect the intention‐to‐treat principle, all conversions from laparoscopy to laparotomy were included in the LAP group. The operative technique used for laparoscopy was standardized, and has been described previously 17 . The operative method was a free choice of the patient and the surgeon, but then followed the guidelines applied in the Cantonal Hospital of Fribourg.…”

Section: Methodsmentioning

confidence: 99%

“…The operative technique used for laparoscopy was standardized, and has been described previously. 17 The operative method was a free choice of the patient and the surgeon, but then followed the guidelines applied in the Cantonal Hospital of Fribourg. Laparoscopic colorectal surgery is regarded as an advanced technique to be carried out only by surgeons experienced in both conventional colorectal surgery and laparoscopy.…”

Section: Operative Approachmentioning

confidence: 99%

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Laparoscopic and Open Colorectal Surgery in Everyday Practice: Retrospective Study

Wahl

Hahnloser

Chanson

et al. 2006

ANZ Journal of Surgery

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Background: Most studies available on laparoscopic colorectal surgery focus on highly selected patient groups. The aim of the present study was to review short‐ and long‐term outcome of everyday patients treated in a general surgery department. Methods: Retrospective review was carried out of a prospective database of all consecutive patients having undergone primary laparoscopic (LAP) or open colorectal surgery between March 1993 and December 1997. Follow‐up data were completed via questionnaire. Results: A total of 187 patients underwent LAP resection and 215 patients underwent open surgery. Follow up was complete in 95% with a median of 59 months (range, 1–107 months) and 53 months (range, 1–104 months), respectively. There were 28 conversions (15%) in the LAP group and these remained in the LAP group in an intention‐to‐treat analysis. The LAP operations lasted significantly longer for all types of resections (205 vs 150 min, P < 0.001) and hospital stay was shorter (8 vs 13 days, P < 0.001). Recovery of intestinal function was faster in the LAP group, but only after left‐sided procedures (3 vs 4 days, P < 0.01). However, preoperative patient selection (more emergency operations and patients with higher American Society of Anesthesiologists (ASA) score in the open group) had a major influence on these elements and favours the LAP group. Surprisingly, the overall surgical complication rate (including long‐term complications such as wound hernia) was 20% in both groups with rates of individual complications also being comparable in both groups. Conclusion: Despite a patient selection favourable to the laparoscopy group, only little advantage in postoperative outcome could be shown for the minimally invasive over the open approach in the everyday patient.

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Section: Methodsmentioning

confidence: 99%

Section: Operative Approachmentioning

confidence: 99%

Laparoscopic and Open Colorectal Surgery in Everyday Practice: Retrospective Study

Wahl

Hahnloser

Chanson

et al. 2006

ANZ Journal of Surgery

View full text Add to dashboard Cite

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Special Considerations in Crohn's Disease

2008

Surgery of the Anus, Rectum &Amp; Colon

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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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Update: Laparoscopic Colon Surgery

Cited by 3 publications

References 4 publications

Laparoscopic and Open Colorectal Surgery in Everyday Practice: Retrospective Study

Laparoscopic and Open Colorectal Surgery in Everyday Practice: Retrospective Study

Special Considerations in Crohn's Disease

Laparoscopic Colorectal Surgery:A Five-Year Experience

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