medigraphic.com
ISSN 1665-2576 (Print)

2012, Number 3

<< Back Next >>

Rev Mex Cir Endoscop 2012; 13 (3)

Laparoscopic colon resection. Comparative study of three surgical techniques

Valadez CD, Enríquez GJA, Ramírez MF, González AJ, Obregón MJ, Vega JM, Decanini TC

Language: Spanish
References: 29
Page: 122-126
PDF size: 68.36 Kb.


ABSTRACT

Introduction: Laparoscopic surgery in the treatment of colon diseases has been associated with a significant improvement in outcomes when compared with conventional surgery. Objective: Review the outcomes in colon surgery, comparing the different techniques performed in our center. Material and methods: Retrospective, comparative, transversal and observational study. Including all patients who underwent colon resection by open surgery, laparoscopic surgery or hand-assisted laparoscopic surgery. From January lst 2005 to August 31 of 2011. Evaluation of sociodemographic characteristics, perioperative and complications. A descriptive analysis was performed with variable rates as a measure of quantity. Chi-square test (χ2) and Student’s t test for independent groups. Established a statistically significant p value less than 0.05. Results: Period of 79 months. 165 resections including three procedures. No differences in age, sex diagnosis, initiation of oral intake and hospital stay. Complications: open surgery five general complications (13.8%), two specific complications (5.55%). Two reoperations (5.55%). One readmission at 30 days (2.85%). Mortality at 30 and 90 days 2.85% secondary to pneumonia. Laparoscopic surgery: three general complications (5.55%). Six specific complications (11.1%). Three conversions to open surgery (5.55%), five reoperations (9.25%), two readmissions at 30 days (3.7%). One death secondary to abdominal sepsis (1.85%). Hand-assisted laparoscopic surgery:1 general complication (1.33%) and one specific complication (1.33%). One reoperation without conversion to open surgery. No readmissions or mortality at 30 and 90 days. Conclusion: We conclude that in our center, the hand-assisted laparoscopic surgery provides the best results with less surgical time, fewer complications, low morbidity and no mortality so far.


REFERENCES

  1. Darzi A. Hand-assisted laparoscopic colorectal surgery. Surg Endosc 2000; 14: 999-1004.

  2. Kang JC, Chung MH, Chao PC et al. Hand assisted laparoscopic colectomy versus open colectomy: a prospective randomized study. Surg Endosc 2004;18: 577-581.

  3. Schadde E, Smith D, Begos DG et al. Hand assisted colorectal surgery at a community hospital. Surg Endosc 2006; 20: 1077-1082.

  4. Nakajima K, Lee SW, Cocilovo C et al. Hand assisted laparoscopic colorectal surgery using gelport: initial experience with a new hand access device. Surg Endosc 2004; 18: 102-105.

  5. Pietrabissa A, Moretto C, Carobbi A et al. Hand assisted laparoscopic low anterior resection: initial experience with a new procedure. Surg Endosc 2002; 16: 431-435.

  6. Chang YJ, Marcello PW, Rusin LC et al. Hand assisted laparoscopic sigmoid colectomy: helping hand or hindrance? Surg Endosc 2005; 19: 656-661.

  7. Aalbers AG, Biere SSAY, Bemelman WA. Hand-assisted or laparoscopic-assisted approach in colorectal surgery: a systematic review and meta-analysis. Surg Endosc 2008; 22: 1769-1780.

  8. Sang WL, Yoo J, Sonoda T et al. Laparoscopic versus hand assisted sigmoidectomy for diverticulitis. Dis Colon Rectum 2006; 49: 464-469.

  9. Anderson J, Luchtefeld M, Dujovny N, Hoedema R. A comparison of laparoscopic, hand-assisted and open sigmoid resection in the treatment of diverticular disease. Am J Surg 2007; 193: 400-403.

  10. Jamali F, Bailey C, Leróy J et al. Rapidly reversible closure of mini-laparotomy during laparoscopic colorectal surgery. Am J Surg 2007; 194: 556-558.

  11. Sajid MS, Qureshi S, Cheek E et al. Elective laparoscopic sigmoid resection for diverticular disease has fewer complications than conventional surgery: a meta-analysis. Am J Surg 2010; 200: 144-161.

  12. Llaguna O, Avgerinos DV, Lugo J et al. Incidence and risk factors for the development of incisional hernia following elective laparoscopic versus open colon resections. Am J Surg 2010; 200: 265-269.

  13. Alvarez-Downing M, Klaassen Z, Orringer R et al. Incidence of small bowel obstruction after laparoscopic and open colon resection. Am J Surg 2011; 201: 411-415.

  14. Cima R, Larson D, Dozois E, Wolff B et al. Experience with 969 minimal access colectomies: the role of hand assisted laparoscopy in expanding minimally invasive surgery for complex colectomies. J Am Coll Surg 2007; 206: 946-950.

  15. Champagne B, Lee E, Valerian B et al. A novel end point to assess a residents ability to perform hand assisted versus straight laparoscopy for left colectomy: is there a really difference? J Am Coll Surg 2008; 207: 54-559.

  16. Sonoda T, Pandey S, Lee S et al. Longterm complications of hand assisted versus laparoscopic colectomy. J Am Coll Surg 2008; 208: 62-66.

  17. Ozturk E, Kiran R, Geisler D et al. Hand assisted laparoscopic colectomy: benefits of laparoscopic colectomy no extra cost. J Am Coll Surg 2009; 209: 242-247.

  18. Larson D, Batdorf N, Touzios J et al. A fast track recovery protocol improves outcomes in elective laparoscopic colectomy for diverticulitis. J Am Coll Surg 2010; 211: 485-489.

  19. Vogel J, Lian L, Campos-Lobato LF et al. Hand assisted laparoscopic right colectomy: how does it compare to conventional laparoscopy? J Am Coll Surg 2011; 212: 367-372.

  20. Litwin D, Darzi A, Kelly J et al. Hand assisted laparoscopic surgery with hand port system: initial experience with 68 patients. Ann Surg 2000; 231: 715-723.

  21. Terrazas F, Nava GA, Ruiz PC et al. Cirugía laparoscópica asistida con la mano en procedimientos de colon. Cir Gen 2009; 31: 39-45.

  22. Cosme RC, Castañeda ML, Guerrero GVH et al. Colectomía laparoscópica manualmente asistida. Cir Gen 2009; 31: 142-146.

  23. Cosme RC, Guerrero GVH, Belmonte MC. Estado actual de la cirugía laparoscópica manualmente asistida de colon y recto. Cir Gen 2009; 31: 180-186.

  24. Arteaga-González I, Malagón AM, Díaz HL et al. Implementación de la cirugía del cáncer de recto por laparoscopia. Cir Esp 2009; 79: 154-159.

  25. Hoffman G, Baker J, Fitchett C et al. Laparoscopic assisted colectomy: initial experience. Ann Surg 1994; 219: 732-743.

  26. Cosme RC, Guerrero GVH, Castañeda ML et al. Colectomía laparoscópica manualmente asistida en cáncer de colon y recto. Rev Mex Cir Endosc 2008; 9: 92-97.

  27. Belmonte MC, Guerrero GVH, Pérez AJ et al. Sigmoidectomía laparoscópica manualmente asistida en el manejo de fístulas secundarias a enfermedad diverticular complicada. Una alternativa segura. Cir Gen 2009; 31: 175-180.

  28. Targarona E, Gracia E, Rodríguez M et al. Cirugía laparoscópica asistida con la mano. Cir Esp 2002; 72: 95-102.

  29. Espitia TF. Cirugía laparoscópica de colon mano-asistida. Cómo lo hago yo. Cir Gen 2009; 31: 196-200.




2020     |     www.medigraphic.com