Laparoscopic Colon Resection: A Case Report
The first case of a villous lesion of the colon removed by laparoscopic-guided surgery is reported. Injection of methylene blue into the lesion facilitated its access and exposure via the laparoscope. A very small skin incision allowed delivery onto the abdominal wall for resection and anastomoses.
Available from: PubMed Central
- "Laparoscopic-assisted colon resections were first reported in 1991.1–4 Initial enthusiasm for these procedures was high, and it was hoped that the benefits of laparoscopic cholecystectomies would also apply to laparoscopic colon surgery. "
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ABSTRACT: There remains a debate in the literature about the advisability of laparoscopic surgery for malignant disease of the colon. Current prospective studies will hopefully answer this question. However, for benign diseases of the colon, we believe laparoscopic surgery offers many advantages including decreased postoperative pain, early discharge from the hospital, and early return to normal activities. We retrospectively reviewed our experience with laparoscopic colectomies for benign disease to see whether these procedures could be done safely and if the proposed advantages could be realized.
Thirty-eight laparoscopic colon resections performed for benign disease were compared to 39 open colon resections with respect to operating times, length of hospital stay, estimated blood loss, days until first postoperative bowel movement, and complications.
The laparoscopic colon resection group had decreased length of stay, less blood loss, earlier return of bowel function, and an equivalent number of complications. Laparoscopic cases did take an average of 24 minutes longer.
The use of laparoscopic colon surgery for benign disease not only affords the patient the advantage of the laparoscopic approach, but also allows the surgeon to gain experience while awaiting the results of ongoing trials for laparoscopic colon surgery in malignant disease.
JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons 02/1999; 3(1):33-7. · 0.91 Impact Factor
Available from: Wai Lun Law
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ABSTRACT: This study aimed to compare the outcomes of laparoscopic resection (LR) with open resection (OR) for right-sided colon cancer.
During the study period from June 2000 to December 2004, 182 patients (84 men) underwent elective resection for cancer of the right colon. Laparoscopic resection was performed in 77 patients, while 105 patients had open operations. Patients who underwent operations on an emergency basis were excluded. Data on the patients' demographics, operative details, and postoperative complications were collected prospectively. The outcomes of patients with laparoscopic resection were compared with those of patients with open surgery.
There was no difference in the age, sex, presence of premorbid medical conditions, and blood loss between the 2 groups. The mean operative time for open resection was 115.4 minutes and that for laparoscopic resection was 165.1 minutes (P<0.001). Among the 77 patients who underwent laparoscopic resection, 7 (9%) required conversion to an open operation. There was no difference in postoperative surgically related complications including wound infection, leakage, intestinal obstruction, postoperative ileus. Nonsurgical-related complications were also similar. The median time to resumption of a normal diet was 3 days and 4 days in the laparoscopic and open groups, respectively. The median hospital stay in patients with laparoscopic resection was significantly shorter than in patients with open surgery (6.0 days vs 7.0 days, P<0.001). The 2-year overall survival rates were 74% in both groups (P=0.904). In the converted to open (LCOR) group, the hospital stay was significantly longer (LR vs OR vs LCOR, 5.5 days vs 7.0 days vs 9.0 days respectively, P<0.001).
Laparoscopic right hemicolectomy is a safe option for cancers of the right colon. It is associated with a shorter hospital stay and earlier resumption of a normal diet. Mortality and morbidity are similar to that with the open approach. There is no compromise in the survival of patients.
JSLS: Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons 01/2007; 11(1):76-80. · 0.91 Impact Factor
Available from: chirurgija.lt
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