>Year 2006, Issue 3
Vega De JM, Decanini TC, Sánchez JGO, Golffier RC
Current state of laparoscopic colectomy in the ABC Medical Center
Cir Gen 2006; 28 (3)
PDF: 4. Kb.
Objective: To assess the results obtained with laparoscopic colectomies (LC).
Setting: American British Cowdray (ABC) Medical Center.
Design: Retrospective, observational, comparative,
Statistics: Percentages and X2 test.
Patients and methods: We analyzed the clinical records of patients subjected to LC from January 1, 2002 to October 15, 2005. Assessed variables were: age, gender, body mass index (BMI), surgical indication, performed procedure, surgical time, transand post-operative morbidity, conversion index (CI), Start of oral feeding (OF), and post-operative hospital stay. Patients were separated in two groups: Group 1, patients intervened by surgeons having performed more than 10 procedures. Group 2, patients treated by surgeons with less than 10 procedures.
Results: Ten surgeons operated on 41 patients; 36.5% (15) were women and 63.5% (26) were men, average age of 57.9 ± 14.2 years. Average BMI was of 25.6 ± 3.9 kg/m2. Surgical indications were: diverticular disease, 80.5% (33), neoplasms 12.2% (5), others 7.3% (3). Procedures performed were sigmoidectomies, 63.5% (26); left hemicolectomies, 14.6% (6), right hemicolectomies 4.9% (2); total colectomies 4.9% (2), and combined procedures 12.2% (5). Average surgical time was of 226.8 ± 158.2 min. Transoperative complications were 2 (4.9%) consisting of pneumatic leak and dehiscence of staples at the rectal stump. Post-operative complications were intestinal occlusion (5), high digestive tract bleeding (3), prolonged ileus (2), wound infection (2), atelectasis (1). Conversion index was 22% (9). Oral feeding started
in average at 3.2 ± 2.44 days. Post-operative hospital stay was in average 5.7 ± 4.3 days. Complications, CI, and surgical time were the variables with statistically significant differences (p ‹ 0.05) between
Conclusion: LC is a feasible approach for the most
frequent surgical pathologies of the colon. It requires a learning and maintenance curve to impact positively on the post-operative evolution and on the use of hospital resources.
||Laparoscopic colectomy, learning curve, surgical time, complications, conversion index.
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>Year 2006, Issue 3