Safety and feasibility of laparoscopic colo-rectal surgery for cancer at a tertiary center in a developing country: Egypt as an example

Amin, Anwar Tawfik; Ahmed, Badawy M.; Khallaf, Salah

doi:10.1016/j.jnci.2015.03.005

Cited by 12 publications

(13 citation statements)

References 25 publications

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“…In a previous study, we showed that laparoscopic colorectal surgery for malignant tumors in developing countries is potentially feasible and safe, and gave similar results for that of multicenter trials [22].…”

Section: Discussionsupporting

confidence: 59%

“…Evidences for the possibility to sterilize the single use devices even with the contamination-challenge are present [25]. For economic issues we safely re-used vessel sealing bipolar devices several times which could be cost-effective [22] [26] [27]. The cost has been reduced by about 70% that means 500 US Dollars at the time of the study which is a good financial benefit regarding Egypt economy.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Amin¹,

Salem²,

Fakhry³

et al. 2017

JCT

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Background: Laparoscopic radical gastrectomy for cancer has significant short-and long-term advantages. The feasibility and safety of laparoscopicdistal gastrectomy for cancer (LADG) is unclear in low to middle income countries as resources are limited. Therefore, the aim of this study was to evaluate the safety and feasibility of (LADG) in low to middle income countries; Egypt as an example. Methods: Thirty four Patients with stage I-II cancer at the pylorus and antrum have been enrolled for LADG between 2012 and 2015 with the reuse of single use vascular sealing device has been evaluated. Results: Finally 27 patients had been included in the study and successful LADG has been done for all selected cases. The average operative time was 151 ± 10 minutes. The average estimated blood loss was 73.3 ± 13 ml. No intra-operative complications have been recorded. The average time for postoperative patient ambulation was 9 hours (SD ± 1.8) and for oral fluid intake was 3.5 SD ± 1 days. The average duration of the hospital stay was 9.3 ± 1.2 days. The average number of retrieved lymph nodes was 21.7 ± 3.8 days. All the cases had free surgical margin. The median number of reuse of the vascular sealing device was 3.8 times (3 -5 times). Conclusion: Laparoscopic distal gastrectomy for cancer could be safe and feasible in developing countries and give similar results for that of developed countries. Safe reuse of single use expensive parts of some instruments for laparoscopy could help in utilization of these advanced surgeries in low to middle income countries. Long term follow up as well as comparative studies with open surgery are required.

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Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Amin¹,

Salem²,

Fakhry³

et al. 2017

JCT

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“…There are similar lags in laparoscopic surgery in many developing countries in Latin America, Asia, and Sub-Saharan Africa 8–12. The importance of these data is put into context when we consider that the cumulative population of the developing world iŝ2 billion persons 13…”

Section: Introductionmentioning

confidence: 99%

Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean

Cawich¹,

Pooran²,

Amow³

et al. 2016

RMHP

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IntroductionThe Caribbean lags behind global trends for volume and complexity of laparoscopic operations. In an attempt to promote laparoscopy at a single facility, a partnership was formed between the University of the West Indies (UWI) and the Port of Spain General Hospital in Trinidad and Tobago. This study seeks to document the effect of this partnership on laparoscopic practice.Materials and methodsIn this partnership, the UWI took the bold step of volunteering to staff a surgical team if the Ministry of Health provided the necessary legislative changes. On August 1, 2013, a UWI team was introduced with a mandate to optimize teaching and promote laparoscopic surgery. The UWI team had a similar staff complement to the existing service-oriented teams. There was no immediate investment in equipment, hospital beds, ICU beds, or operating room space. Therefore, the new team was introduced with limited change in existing conditions, resources, and equipment.ResultsThere were 252 laparoscopic operations performed over the study period. After introduction of the UWI team, there was an increase in the mean number of unselected laparoscopic operations (3.17 vs 10.83 cases per month; P<0.001; 95% confidence interval [95% CI] −8.5 to −6.84; standard error of the difference [SED] 0.408), the mean number of basic laparoscopic operations (3.17 vs 6.94 cases per month; P<0.0001; 95% CI −4.096 to −3.444; SED 0.165), the mean number of advanced laparoscopic operations (0 vs 3.89; P<0.0001), the number of teams undertaking unselected laparoscopic operations (2 vs 5), and the number of teams independently performing advanced laparoscopic operations (0 vs 4).ConclusionAt this facility, we have demonstrated a significant increase in laparoscopic case volume and complexity when partnerships were formed between the UWI and this service-oriented hospital. Continued cross-fertilization and distribution of skill sets across the surgical community can reasonably be expected. We also identified maneuvers that can be used as a template to build laparoscopic services in other service-oriented hospitals in developing nations.

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“…In Egypt, because of limited resources and the expenses of MIS, laparoscopic colorectal surgery is restricted in use for a few tertiary centers with only few cases being treated every year. However, studies from Egypt have showed that various types of laparoscopic colo-rectal surgery for cancer with the adoption of the standardized operative steps respecting the oncologic fundamentals could be performed successfully without jeopardizing oncologic safety [11] .…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus Open Rectosigmoid Cancer Resection: A comparative Study

Balbola

Elramah

Ibrahim

et al. 2022

International Journal of Medical Arts

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Article informationBackground: Although widely performed the usefulness of Laparoscopic surgery for rectosigmoid and upper rectal cancer resection compared with open surgery has not been established sufficiently. The aim of this study was to compare the short-term, oncologic, outcomes of laparoscopic and open resection for recto-sigmoid and / or upper rectal cancer in the same time period. Patients and Methods: This prospective study included 50 patients with rectosigmoid and upper rectal cancer diseases, admitted to Al Azhar New Damietta University hospital and Damietta cancer Institute surgery departments between December 2016 and December 2018. Patients were randomly divided into two groups: [Group 1: "25 patients"] subjected to laparoscopic interventions, and [Group 2: "25 patients]" subjected to open surgery. Data were collected and Shortterm outcomes and long-term prognosis were analyzed. Results:The mean operative time was significantly increased in the LR group than OR group [LR 198.88± 18.7, OR 183.4± 20.5 minutes, p =0.01] as well as the hospital stay [LR 8.8± 2, OR 7.4± 2.9 days, p =0.013]. However, LR group was quicker to recover in term of mobilizing early, recovery of bowel function, and early toleration of diet and fluid and this difference was only statistically significant for oral fluid but not for diet [p= 0.078; 0.17 respectively]. There was no significant difference between both groups in tumor characteristics as locations, gross tumor morphology, staging, and distance to the distal margin. Also, both groups had comparable intraoperative and post-operative adverse events. Conclusion:Laparoscopic surgery for rectosigmoid cancer and rectal cancer offers numerous advantages beyond aesthetics aspects and is possible and safe with comparable oncological clearance to open surgery and might be considered an option of care when both approaches are suitable.

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Safety and feasibility of laparoscopic colo-rectal surgery for cancer at a tertiary center in a developing country: Egypt as an example

Abstract: Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.

Cited by 12 publications

References 25 publications

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Laparoscopy Assisted Distal Gastrectomy for Cancer at a Tertiary Center in Egypt. Is It Safe and Feasible?

Impact of a medical university on laparoscopic surgery in a service-oriented public hospital in the Caribbean

Laparoscopic versus Open Rectosigmoid Cancer Resection: A comparative Study

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