The usefulness, indications, and complications of laparoscopy-assisted colectomy in comparison with those of open colectomy for colorectal carcinoma

Abstract

The technique of laparoscopy-assisted colectomy (LAC) was developed for benign and malignant diseases of the colon and rectum; however, its feasibility and the associated clinical outcome remain unclear. We reviewed 45 patients who underwent LAC (LAC group) and 62 patients who underwent traditional open surgery (Open group) for colorectal carcinoma in our hospital, and compared the clinical data between the two groups in an effort to determine whether LAC is really minimally invasive and if it enhances the quality of life. So that the backgrounds of the patients in both groups were almost the same, we only compared data of patients with colorectal carcinoma of stages 0, I, and II. The duration of surgery in the Open group was significantly shorter for all procedures except sigmoid resection, but the blood loss was not significantly different between any of the procedures except for right colectomy. The time to the first passing of flatus and restarting oral intake, length of hospital stay, and duration of epidural analgesia were significantly shorter in the LAC group. The morbidity and mortality rates in the LAC group were almost the same as those in the Open group at 29.5% and 3.3% versus 22.6% and 1.6%, respectively. However, five major complications of LAC for advanced colorectal carcinomas might be prevented by performing an open procedure. In conclusion, LAC is a safe and minimally invasive surgical technique following which we can expect a faster recovery; however, patients with advanced colorectal carcinomas must be carefully selected for this operation.

Laparoscopic resection of colon Cancer: Consensus of the European Association of Endoscopic Surgery (EAES)

“…In some studies, benign lesions were also included [77], and rectal procedures were excluded in only one RCT [89]. In two RCT [77,87] and in five nonrandomized comparative studies, the intention-to-treat principle was violated [75,88,[90][91][92], resulting in selection bias, possibly favoring the laparoscopic group. Also, the length of the retrieved bowel segments and tumor-free margins were comparable [5,77,87,93,94] (Table 4).…”

Acesso vídeo-laparoscópico no tratamento cirúrgico da diverticulite aguda

“…Por exemplo, o tempo de internação tende a ser menor para as séries de doentes submetidos à laparoscopia (18)(19)(20)(21) , mas em algumas séries este tempo é equiparável (22,23) . Este dado pode ser atribuído a menor tempo de íleo paralítico em algumas series (19,20,21,22,24,25,26) , mas que discordam de outras em que este tempo também é similar (23,27) . A taxa de complicações costuma ser apontada como semelhante (18,24,26) , se não menor que nas operações abertas (28) , com raras exceções (23) .…”

“…Este dado pode ser atribuído a menor tempo de íleo paralítico em algumas series (19,20,21,22,24,25,26) , mas que discordam de outras em que este tempo também é similar (23,27) . A taxa de complicações costuma ser apontada como semelhante (18,24,26) , se não menor que nas operações abertas (28) , com raras exceções (23) . Em relação à necessidade de medicação analgésica, a maioria dos estudos indicam ser menor na laparoscopia (24,25,26,28) , mas há series em que o consumo não foi significativamente diferente ( 27) .…”

“…A taxa de complicações costuma ser apontada como semelhante (18,24,26) , se não menor que nas operações abertas (28) , com raras exceções (23) . Em relação à necessidade de medicação analgésica, a maioria dos estudos indicam ser menor na laparoscopia (24,25,26,28) , mas há series em que o consumo não foi significativamente diferente ( 27) .…”

Das Patientenbefinden in der fr�hen postoperativen Phase

“…Marubashi et al [15] verglichen laparoskopisch assistierte mit konventionell durchgeführten Kolonresektionen. Die Ergebnisse sind mit den Ergebnissen unserer Studie kongruent.…”