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2011, Number 4

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Rev Mex Cir Endoscop 2011; 12 (4)

Utility of hand-assisted laparoscopic surgery for colon cancer

Pérez AJ, Guerrero GVH, Arciniega HJA, López RMA

Language: Spanish
References: 28
Page: 144-148
PDF size: 52.23 Kb.


ABSTRACT

Despite its introduction in 1991, laparoscopic colectomy hasn’t be adopted in many centers because it requires a specialized training with a steep learning curve. Hand-assisted laparoscopic surgery is an alternative technique to the approach at complex colorectal surgery than preserves the benefits of laparoscopic surgery. To describe the utility at short and long-term there were reviewed the files of 291 patients who underwent hand-assisted colorectal resections over a 5-year period. This was an analytic, retrospective and descriptive study involving demographics variables, tumor location, histological classification, tumor stage, procedures realized, operative time, estimated blood loss, conversion rate, total number of resected lymph nodes, postoperative length of stay, resumption of gastrointestinal function, postoperative complications, recurrence and mortality in short and long-term. A total of 291 hand-assisted colorectal resections were documented, Age average was 59 years, 52% were women, and the average body mass index was 28 kg /m2. The most common histological type was adenocarcinoma moderately differentiated in 56%; the most common location was in upper third of the rectum in 49.1%. Low anterior resection was performed to143 patients (49.1%), sigmoid resection were performed to 84 patients (28.9%). The average postoperative length of stay was 13 (range 4-22), the average days for gastrointestinal resumption were 3 (range 1-5). The conversion rate was 5.8%, postoperative complications occurred in12.7%, reoperation in 5.2% and mortality in 0.7 at 30% days. The recurrence rate at 60 months was 6.2%; the mortality rate at 60 months was 11.7%. We conclude that hand-assisted laparoscopic surgery is a useful and secure procedure for colon cancer patients. It preserves nearly all the benefits of laparoscopic surgery with similar oncologic results than open procedures.


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