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Laparoscopic Colonic Resection (laparoscopic + colonic_resection)
Selected AbstractsLaparoscopic colonic resection in inflammatory bowel disease: minimal surgery, minimal access and minimal hospital stayCOLORECTAL DISEASE, Issue 9 2008E. Boyle Abstract Objective, Laparoscopic surgery for inflammatory bowel disease (IBD) is technically demanding but can offer improved short-term outcomes. The introduction of minimally invasive surgery (MIS) as the default operative approach for IBD, however, may have inherent learning curve-associated disadvantages. We hypothesise that the establishment of MIS as the standard operative approach does not increase patient morbidity as assessed in the initial period of its introduction into a specialised unit, and that it confers earlier postoperative gastrointestinal recovery and reduced hospitalisation compared with conventional open resection. Method, A case,control study was undertaken on laparoscopic resection (LR) vs open colon resection (OR) for IBD. The LR group was collated prospectively and compared with a pathologically matched historical control set. Outcomes measured included: postoperative length of stay, time to normal bowel function and postoperative morbidity. Statistical analysis was performed using spss. Results, Twenty-eight patients were investigated (14 LR, 14 OR). The two groups were matched for type of operation, type of disease and age. There were no conversions in the LR group. Morbidity and readmissions did not differ significantly between the groups. Those undergoing laparoscopic resection had a quicker return to diet (median 2 vs 4 days; P = 0.000002), time to first bowel motion (2 vs 4 days; P = 0.019) and shorter postoperative length of stay (5.5 vs 12.5; P = 0.0067). Conclusion, These findings support the routine use of MIS for the elective surgical management of IBD in our department. Patients undergoing laparoscopic colectomies for IBD can expect faster return of gastrointestinal function and shorter hospitalisation. [source] Laparoscopic colonic surgery , mission accomplished or work in progress?COLORECTAL DISEASE, Issue 6 2006H. Kehlet Abstract Laparoscopic colonic resection may facilitate early postoperative recovery due to reduced surgical stress, pain and ileus. However, large randomised studies have only shown marginal improvements in outcome compared with open surgery, reporting a median hospital stay of about 5,7 days. Concomitant with these developments multimodal rehabilitation, which involves a revision of general postoperative care principles, improved pain relief with epidural analgesia and early oral nutrition and mobilization, has demonstrated greater improvements in recovery after open surgery, resulting in a median hospital stay of about 2,4 days. Recent single centre, randomised studies where laparoscopic and open colonic resection are combined with multimodal rehabilitation have not resolved the debate regarding which is the optimal operative technique. Therefore, new strategies are required to integrate laparoscopy with multimodal rehabilitation in order to establish its advantages, cost effectiveness and indications in specific groups of patients or colorectal procedures, thus justifying widespread application of the laparoscopic technique. [source] Clinical outcomes of laparoscopic colonic resection for diverticular disease in Japanese patientsASIAN JOURNAL OF ENDOSCOPIC SURGERY, Issue 3 2010T Akagi Abstract Introduction: Indications for laparoscopic surgery for colonic diverticular disease have not been established in Japan despite this being a relatively common disease. We studied surgical outcomes of laparoscopic colon resection (LCR) versus open colon resection (OCR) for diverticular disease. Methods: We retrospectively reviewed surgical outcomes of 21 patients with colonic diverticulitis. Results: Of these 21 patients, 11 underwent OCR, and 10 underwent LCR. There were no differences in age, sex, and BMI between the groups. Diverticulitis in the LCR group, compared to the OCR group, was characterized as being of the uncomplicated type with a right-side location (P<0.01). Volume of blood loss and duration of postoperative hospital stay were less in the LCR group than in the OCR group (P<0.05). There were no significant differences in operative times, duration to start of solid food intake, and rate of postoperative complications. Conclusion: These results suggest that LCR for diverticulitis can be performed safely and less invasively without increased morbidity for uncomplicated diverticulitis. Further studies will be needed to determine the benefits of LCR for complicated diverticulitis. [source] Australasian Laparoscopic Colon Cancer Study shows that elderly patients may benefit from lower postoperative complication rates following laparoscopic versus open resection,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 1 2010R. A. Allardyce Background: A retrospective analysis of age-related postoperative morbidity in the Australia and New Zealand prospective randomized controlled trial comparing laparoscopic and open resection for right- and left-sided colonic cancer is presented. Methods: A total of 592 eligible patients were entered and studied from 1998 to 2005. Results: Data from 294 patients who underwent laparoscopic and 298 who had open colonic resection were analysed; 266 patients were aged less than 70 years and 326 were 70 years or older (mean(s.d.) 70·3(11·0) years). Forty-three laparoscopic operations (14·6 per cent) were converted to an open procedure. Fewer complications were reported for intention-to-treat laparoscopic resections compared with open procedures (P = 0·002), owing primarily to a lower rate in patients aged 70 years or more (P = 0·002). Fewer patients in the laparoscopic group experienced any complication (P = 0·035), especially patients aged 70 years or above (P = 0·019). Conclusion: Treatment choices for colonic cancer depend principally upon disease-free survival; however, patients aged 70 years or over should have rigorous preoperative investigation to avoid conversion and should be considered for laparoscopic colonic resection. Registration number: NCT00202111 (http://www.clinicaltrials.gov). Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] | ||||||||||