Laparoscopic colorectal surgery: A prospective assessment and current perspective

Sd, Wexner; Cohen, Stephen M.; Johansen, Olaf B.; Nogueras, Juan J.; Jagelman, David G.

doi:10.1002/bjs.1800801238

Cited by 152 publications

(54 citation statements)

References 10 publications

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“…Dies gilt noch in weit ho È herem Maûe fu È r Patienten mit malignen Grunderkrankungen [27,47]. Bei der Beurteilung von Studien muû das Problem «Lernkurve» zunehmende Beru È cksichtigung finden [28,48]. Die Quantifizierung dieses Pha È nomens ist ein schwieriges Unterfangen, allerdings ist zumindest seine orientierende Abscha È tzung zur Qualita È tsbeurteilung unabdingbar.…”

Section: Spezielle Indikationen Der Laparoskopischen Kolorektalen Chiunclassified

Ergebnisse der laparoskopischen kolorektalen Chirurgie

Scheidbach¹,

Schneider²,

Diddens³

et al. 2000

Visc Med

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Laparoscopic operative techniques may be of advantage to the patient undergoing colorectal surgery. Of fundamental importance, however, is the careful selection of suitable patients and indications. Even with indications of the colorectum, the many benefits of the minimally invasive approach may be fully effective. Overall morbidity associated with the laparoscopic modality is lower than with conventional surgery. There is a clear relationship between operative experience, conversion rate, and the complication rate achieved (learning curve). Laparoscopic colorectal procedures can also be performed in the elderly patient, in whom – provided the indication has been properly established – the minimally invasive modality is of particular benefit. More recent studies on the topic of laparoscopic colorectal surgery focus, in contrast to earlier studies, less on the feasibility and safety of the technique but more on the criteria of quality of treatment. Surgical treatment of diverticulitis of the sigmoid colon has benefited from the introduction of laparoscopic procedures. In general, laparoscopic procedures here should be restricted to less developed stages. Rectal prolapse is considered to be an ideal indication for a laparoscopic procedure. The use of such interventions to treat colorectal carcinoma, however, continues to be controversial. In the case of low tumour stages located at a favourable site, and provided that the monitoring of the patient be carried out under the more stringent requirements demanded by prospective study protocols, there would appear to be no objection, on the basis of current data, to the use of a laparoscopic procedure. Whether the use of the laparoscopic modality can reduce costs has not been unequivocally established at present, but is considered to be highly likely.

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Section: Spezielle Indikationen Der Laparoskopischen Kolorektalen Chiunclassified

Ergebnisse der laparoskopischen kolorektalen Chirurgie

Scheidbach¹,

Schneider²,

Diddens³

et al. 2000

Visc Med

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show abstract

“…It does not have the same theoretical advantages as a laparo scopic cholecystectomy, because the 'access trauma' is a smaller proportion of the total 'operative trauma', and an abdomoinal inci sion is required to remove the bowel speci men. It is, therefore, not surprising that some authors have found no substantial difference in the rates of postoperative recovery after the laparoscopic procedure [124,125]. In cancer resections, there is debate as to whether the laparoscopic approach is oncologically sound.…”

Section: Laparoscopic Colonic Proceduresmentioning

confidence: 99%

“…In the series of Wexner et al [124] of 74 pro cedures, 4 patients developed intra-abdomi nal abscesses (2 from accidental enterotomies and 2 from anastamotic leakage) and 4 re quired open surgery for major haemorrhage (2 trocar injuries to epigastric vessels, 1 Veress needle injury to the aorta, and 1 iliac injury from dissection). There are anecdotal reports of ureteric injuries.…”

Section: Laparoscopic Colonic Proceduresmentioning

confidence: 99%

Laparoscopic Interventions in the Gut: Yesterday, Today, and Tomorrow

McMahon

O’Dwyer²,

Baxter³

1996

Dig Dis

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The development of laparoscopic interventional surgery has brought about a revolution in general surgery over the past 5 years. Laparoscopic cholecystectomy has now become the treatment of choice for symptomatic cholelithiasis because of a reduction in access trauma, resulting in less postoperative pain and a faster recovery. Laparoscopic fundoplication for gastroeosophageal reflux also looks to be a promising procedure which will probably become generally accepted. Laparoscopic hernia repair, although widely practised, has raised question marks because of doubt about recurrence rates and major complications such as intestinal obstruction. Laparoscopic colectomy has similarly raised concerns about complication rates and tumour recurrence rates. Laparoscopic appendicectomy offers marginal benefits over open appendicectomy. Virtually every other intra-abdominal procedure has been performed laparoscopically, but most require further evaluation.

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“…Operative complications such as major haemorrhage, inadvertent enterotomy, ureteral injury, and major vessel laceration have all been reported, with rates ranging from 0 to 12% [6, 12, 14, 46, 51, 56, 57, 59]. The overall morbidity rate is between 6 and 39% [59,68,69,70,71,72,73,74,75,76,77]. …”

Section: Complicationsmentioning

confidence: 99%

Laparoscopy for Colorectal Malignancy

Pillinger

Monson

2005

Dig Surg

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Laparoscopy for colorectal pathology is technically demanding with a steep learning curve. In expert hands, there is no doubt that there is a place for laparoscopy in the operative armamentarium for the treatment of benign disease. The question of its application in the treatment of carcinoma is more difficult to address. The evidence available suggests that laparoscopic resection is a feasible and appropriate option for the treatment of colorectal carcinoma. The skill and technology to perform the procedure are developing apace, and level 1 evidence to support it is tantalizingly close. This paper will outline the development of the technique, the operative approach, and the available evidence for its use in the treatment of carcinoma.

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Laparoscopic colorectal surgery: A prospective assessment and current perspective

Cited by 152 publications

References 10 publications

Ergebnisse der laparoskopischen kolorektalen Chirurgie

Ergebnisse der laparoskopischen kolorektalen Chirurgie

Laparoscopic Interventions in the Gut: Yesterday, Today, and Tomorrow

Laparoscopy for Colorectal Malignancy

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