Laparoscopic vs Open Colectomy for Colon Cancer: Results from a Large Nationwide Population-based Analysis

Steele, Scott R.; Brown, Tommy A.; Rush, Robert M.; Martin, Matthew J.

doi:10.1007/s11605-007-0286-9

Cited by 114 publications

(94 citation statements)

References 46 publications

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“…4,[7][8][9][10][11][12]14,[20][21][22] However, proficiency, as opposed to competency, implies attainment of some level of mastery of the technique that comes with increased experience and results in improved outcomes rather than the bare minimum needed to complete an operation safely. Achieving proficiency associated with the technique appears to occur over a longer period and increased volume of cases.…”

Section: Commentmentioning

confidence: 99%

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Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

et al. 2012

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Section: Commentmentioning

confidence: 99%

“…[2][3][4] These studies face a number of limitations in their approach including different demographics of the study population, the age of the operating surgeon as well as his or her surgical experience, and the varying difficulty of the operations themselves. 5,6 ARCH SURG/ VOL 147 (NO.…”

Section: Online First Invited Critiquementioning

confidence: 99%

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

et al. 2012

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“…Although S-LCS is a more challenging technique and lasts longer than C-LCS, in our series the mean operation time was 177 minutes (3,6). The factors that lengthened our operation times are; 2 patients requiring subtotal colectomy, dissection of the shortened mesentery in patients with diverticular disease, and additional surgery requirements in 4 patients.…”

Section: Discussionmentioning

confidence: 75%

“…In the USA conventional laparoscopic colorectal surgery is performed by 25% of surgeons (5,6). Since experienced surgeons are currently in the process of learning conventional laparoscopic procedures, it remains to be seen how popular S-LCS will get.…”

Section: Discussionmentioning

confidence: 99%

Single-incision (with multi-input single-port) laparoscopic colorectal procedures: Early results

Ertem

Gök

Özveri

2013

UCD

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Objective: Single incision laparoscopic surgery (SILS) is a "scar-less" new surgical technique which has been gaining popularity over recent years. In comparison to conventional multiport laparoscopic surgery, SILS is introduced as a less invasive method. This technique has also been applied to colorectal surgery. The aim of the presenting study is to investigate the applicability of SILS and report short term results. Material and Methods:We evaluated prospectively collected data of 24 patients who had been operated with "Single Incision Laparoscopic Colon Resection (SILCR)" in our clinic between June 2011-June 2013. Informed consent was obtained from all patients before surgery. Patient data such as ASA and BMI values, need for additional surgery, tumors, number of lymph nodes resected, length of hospital stay, length of surgery, timing of flatus, time to start oral feeding and complications were recorded.Results: SILCR was performed in 24 patients. In 13 patients, SILCR was performed for cancer treatment. There was no need for extra ports, conversion to open surgery and stoma creation was also not necessary. Drain was placed in 4 patients. Overall complication rate was 12.5%. The mean number of lymph nodes in 13 patients who underwent SILCR for tumor was found to be 23 (14-33). The mean operative time and length of hospital stay was 177 minutes (110-363) and 5.35 days (4-11) respectively. Anastomotic leakage was not seen in any of the patients. In one patient, urinoma formation due to ureteral leakage was seen which resulted from thermal injury. Conclusion:When we compare other series with almost the same number of patients' reported SILS results in the literature, we believe that we could draw conclusions from our data. SILS appears to have comparable results to conventional multiport laparoscopic surgery in the hands of experienced surgeons. It seems advantegous as it can be done with conventional laparoscopic instruments in a "scar-less" manner. Prospective randomized trials are necessary to define the benefits of one procedure over the other. Original Investigation INTRODUCTIONExpertise in laparoscopy over 20 years and the advances in technology expand the role of NOTES and single port or single incision surgeries within the spectrum of minimally invasive surgery. This technique has rapidly gained acceptance with support from flexible hand devices, telescopes with rotating ends and port systems that can be placed through 2-5 cm incisions without gas leakage. This technique was first used in right-hemicolectomy by Remzi et al. for a large cecal polyp (1). Similar to the way laparoscopic surgery began; single incision surgery was first used in cholecystectomy and gained popularity thereafter. Colorectal procedures with this method have also begun during the same period. According to results from studies on single incision surgical procedures, this method has a slight advantage over conventional laparoscopic procedures with less pain, less length of hospital stay and faster recovery (2-4).

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“…With the advancement of surgical techniques, there is a shift towards laparoscopic abdominal surgery that is considered less invasive than the open technique [6]. Following laparoscopic colorectal surgery, patients are allowed oral intake soon after operation.…”

Section: Introductionmentioning

confidence: 99%

Patient-Controlled Analgesia versus Oral Controlled-Release Oxycodone – Are They Interchangeable for Acute Postoperative Pain after Laparoscopic Colorectal Surgeries?

Ho¹

2008

Oncology

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Background: Standard therapy for postoperative pain after laparoscopic colorectal surgeries at the Tan Tock Seng Hospital consists of intravenous morphine via patient-controlled analgesia (PCA) for the first 24–48 h, followed by oral analgesics. We compared the efficacy and safety of oral controlled-release (CR) oxycodone hydrochloride (OxyContin® tablets) and PCA after laparoscopic colorectal surgeries. Methods: Between March and August 2006 (phase 1 study), 14 patients underwent laparoscopic colectomy, laparoscopic hemicolectomy or laparoscopic-assisted anterior resections. All patients were on oral CR oxycodone with oral immediate-release oxycodone on an as-needed basis for breakthrough pain. Pain intensity, analgesic use, length of hospital stay and side effects were evaluated. These were compared to data obtained from a second study of a similar design where 9 patients underwent similar operations from October 2006 to July 2007 (phase 2 study) and were on PCA morphine. Results: All patients in the CR oxycodone and PCA morphine groups needed the opioid medication for only 2 days. There was no difference in mean (range) postoperative pain intensity scores between patients on oxycodone and those on PCA morphine for the 1st postoperative day [2.07 (0–5) vs. 2.78 (2–4) on a Visual Analogue Scale (VAS) from 0 to 10; p = 0.10] and the 2nd postoperative day [1.14 (0–2) vs. 1.67 (0–3); p = 0.10]. Generalized estimating equations with linear link function confirmed that there was a significant relief of pain in patients after operation. On average, the VAS score of pain was 1.00 units lower on day 2 when compared with day 1 (p < 0.01). The mean (range) doses of oxycodone used on the 1st and 2nd postoperative day were 13.57 mg (10–30) and 15.36 mg (10–30), and the mean (range) doses of morphine used on the 1st and 2nd postoperative day were 14.9 mg (8–28) and 16.3 mg (4–31), respectively. Incidence of nausea and vomiting was 14.2 and 20% for the CR oxycodone and PCA groups, respectively. Conclusions: Oral CR oxycodone 20 mg per day is a cheaper, convenient and an efficacious alternative analgesic to PCA opioids after laparoscopic colorectal surgery.

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Laparoscopic vs Open Colectomy for Colon Cancer: Results from a Large Nationwide Population-based Analysis

Abstract: Laparoscopy for colon cancer is associated with improved outcomes in unadjusted analysis and similar charges compared to open resection. We found no influence of race or payer status on the utilization of a laparoscopic approach.

Cited by 114 publications

References 46 publications

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

Technical Proficiency in Hand-Assisted Laparoscopic Colon and Rectal Surgery

Single-incision (with multi-input single-port) laparoscopic colorectal procedures: Early results

Patient-Controlled Analgesia versus Oral Controlled-Release Oxycodone – Are They Interchangeable for Acute Postoperative Pain after Laparoscopic Colorectal Surgeries?

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