Utilization of Laparoscopic Colectomy in the United States Before and After the Clinical Outcomes of Surgical Therapy Study Group Trial

Abstract

Within 3 years after publication of the COST trial, the use of laparoscopic resection for colon cancer approached that of benign disease. However, almost 90% of cases are still performed open and utilization remains influenced by socioeconomic factors.

Comparison of Open Colorectal Surgeries versus Laparoscopic and Lap Assisted Colorectal Surgeries for Short Term Outcomes in Colorectal Malignancy

“…In our study, we used the requirement of perioperative blood transfusion as an indicator for intraoperative blood loss. Our results were similar to previous studies (9,11) . The requirement of blood transfusion was lesser for laparoscopic group.…”

Transanal total mesorectal excision (taTME) for rectal cancer: a training pathway

“…The execution of LAR with TME using a minimally invasive surgical approach (laparoscopic, robotic) is a technically challenging operation with reduced working space, retraction capabilities, and visibility. There has been an exceedingly slow adoption rate of this technique with \10 % minimally invasive surgical procedures being performed for rectal cancer in the USA by 2011 [2]. These challenges led to the trend toward increased interest and utilization of robotic rectal surgery.…”

“…This pneumatic pressure dissection does not occur when using a transabdominal approach to rectal surgery. (2) The retraction of the rectum is technically less difficult from the transanal approach as rectal retraction is a ''forward pushing motion'' for transanal rectal surgery compared to a ''pulling up and out of the pelvis motion'' required for transabdominal rectal surgery. (3) Rectal division can be performed without using modern endoscopic staplers with a transanal approach.…”

The Effect of Resection Methods on Outcomes in Colorectal Cancers: Does Conversion Matter?

“…3 Despite the ongoing discussion as to whether laparoscopic resections can ensure better results than open surgery, they are performed with increasing frequency. 4,5 However, although their short term and oncological outcomes are similar, the percentage of laparoscopic resections performed is still lower than open surgery. 6 In the catalogue of minimally invasive surgical interventions, the term "conversion" has now been added to the classic resection methods.…”

“…15,34 In our study, the number of removed lymph nodes was similar in all groups and no statistically significant differences were found between the resection methods. The average tumor size in colorectal cancers is 3.5 (1-7) cm in the laparoscopic group and 3.9 (1)(2)(3)(4)(5)(6)(7)(8) in the open surgery group. 34 In our study, although average tumor size was larger in the conversion group, no statistically significant difference was found among the groups.…”