Hand-assisted laparoscopic colectomy vs open colectomy: a prospective randomized study

Abstract

Background: We compared the perioperative parameters and outcomes achieved with hand-assisted laparoscopic colectomy (HALC) vs open colectomy (OC) for the management of benign and malignant colorectal disease, including cancer patients treated with curative intent. Methods: Sixty eligible patients were randomized to either HALC (n = 30) or OC (n = 30) treatment groups. We used Pearson's chi-square and two-sample t-tests to compare the differences in demographics and perioperative parameters. Results: There were no significant differences in age, gender distribution, disease pattern, operative procedure, comorbidity, or history of abdominal surgery. The HALC patients had significantly shorter hospital stays and incision lengths, faster recovery of gastrointestinal function, less analgesic use and blood loss, and lower pain scores on postoperative days 1, 3, and 14. There were no significant differences in operative time, complications, or time to return to normal activity. Conclusion: Hand-assisted laparoscopic colectomy (HALC) is safe and produces better therapeutic results in terms of perioperative parameters than OC.

Systemic inflammatory response syndrome after hand-assisted laparoscopic distal pancreatectomy

“…Third, reconstruction procedures that are difficult in laparoscopic surgery are unnecessary. The clinical benefits of HALS have been shown in several procedures, including colorectal resection [8], splenectomy [17], and live-donor nephrectomy [23]. The greatest benefit of HALS is that the safety that has already been established in open surgery is combined with the advantages of minimal invasiveness [11,18].…”

Hand-assisted versus laparoscopic-assisted colorectal surgery: Practice patterns and clinical outcomes in a minimally-invasive colorectal practice

“…Several studies have examined the applicability of this technique to specific advanced colorectal procedures [9,10] but few have analyzed the role of HALS in a clinical practice involving patients with a variety of benign and malignant colorectal diseases [10][11][12][13]. Although available randomized comparisons of HALS versus LA have suggested that HALS maintains the patient-related benefits of LA colectomy while shortening operative times and allowing surgeons to perform more complex cases [1,14] these studies suffered from small sample sizes.…”

Hand‐Assisted Laparoscopic Ovariohysterectomy in the Mare

“…By far the most common indication is nephrectomy (Kercher et al 2003, Maartense et al 2004, Gaston et al 2004, Brown et al 2004). Other indications include liver resection (Fong et al 2000, Shimizu et al 2003, Hayakawa et al 2004), pancreas surgery (Doi et al 2003), splenectomy (Takahashi et al 2004, Bermas et al 2004, esophagectomy (Romanelli et al 2001), gastric bypass surgery and gastrectomy (Romanelli et al 2001, Sundbom andGustavsson 2004), colorectal surgery (Loungnarath and Fleshman 2003, Nakajima et al 2004, Kang et al 2004), aortoiliac surgery (Wijtenburg et al 2003), and hysterectomy (Pelosi and Pelosi 1999).…”