A totally mini-invasive approach for colorectal laparoscopic surgery

被引:34
作者
Anania, Gabriele [1 ]
Santini, Mirco [1 ]
Scagliarini, Lucia [1 ]
Marzetti, Alice [1 ]
Vedana, Laura [1 ]
Marino, Serafino [1 ]
Gregorio, Claudio [1 ]
Resta, Giuseppe [1 ]
Cavallesco, Giorgio [1 ]
机构
[1] Med Univ Ferrara, Dept Surg, Arcispedale S Anna, I-44121 Ferrara, Italy
关键词
Anastomosis; Cancer; Colorectal disease; Surgery; Laparoscopy; COLON-CANCER; OPEN COLECTOMY; RIGHT HEMICOLECTOMY; INTRACORPOREAL ANASTOMOSIS; LEARNING-CURVE; TRIAL; EXTRACORPOREAL; EXPERIENCE; RESECTION;
D O I
10.3748/wjg.v18.i29.3869
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
AIM: To study the short-term outcome of patients treated with laparoscopic right colectomy and how intracorporeal anastomosis has improved the outcome. METHODS: We retrospectively examined all patients affected by colorectal cancer who underwent a laparoscopic right colectomy between January 2006 and December 2010 in our department. Our evaluation criteria were: diagnosis of colorectal carcinoma at presurgical biopsy, elective surgery, and the same surgeon. We excluded: emergency surgery, conversions from laparotomic colectomy, and other surgeons. The endpoints we examined were: surgical time, number of lymph nodes removed, length of stay (removal of nasogastric tube, bowel movements, gas evacuation, solid and liquid feeding, hospitalization), and major complications. Seventy-two patients were divided into two groups: intracorporeal anastomosis (39 patients) and extracorporeal anastomosis (33 patients). RESULTS: Significant differences were observed between intracorporeal vs extracorporeal anastomosis, respectively, for surgical times (186.8 min vs 184.1 min, P < 0.001), time to resumption of gas evacuation (3 d vs 3.5 d, P < 0.001), days until resumption of bowel movements (3.8 d vs 4.9 d, P < 0.001), days until resumption of liquid diet (3.5 d vs 4.5 d, P < 0.001), days until resuming a solid diet (4.6 d vs 5.7 d, P < 0.001), and total hospitalization duration (7.4 d vs 8.5 d, P < 0.001). In the intracorporeal group, on average, 19 positive lymph nodes were removed; in the extracorporeal group, on average, 14 were removed P < 0.001). Thus, intracorporeal anastomosis for right laparoscopic colectomy improved patient outcome by providing faster recovery of nutrition, faster recovery of intestinal function, and shorter hospitalization than extracorporeal anastomosis. CONCLUSION: Short-term outcomes favor intracorporeal anastomosis, confirming that a less traumatic surgical approach improves patient outcome. (c) 2012 Baishideng. All rights reserved.
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收藏
页码:3869 / 3874
页数:6
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