BACKGROUND: Thorough training is essential to the success of colorectal laparoscopic surgery (LPS). The aim of this study was to evaluate the results of a 3-month training period in LPS. METHODS: Before beginning the study, the surgical team attended several courses of LPS and spent a long time working at a large animal facility to perfect laparoscopic techniques. Twenty-six consecutive patients underwent LPS in a 3-month training period. Controls (n = 26) who underwent open colorectal surgery (LPT) were selected to match the LPS patients for age, gender, primary disease, type of surgery, comorbidity, and nutritional status. RESULTS: Conversion to open surgery was necessary in one patient (3.8%). The operative time was 1 h longer for LPS than LPT (p < 0.001). The mean number of lymph nodes harvested was 17 in LPS and 18 in LPT (p = 0.76). The first flatus (p < 0.02) and bowel movement (p < 0.002) occurred earlier in the LPS group. The postoperative infection rate was 11.5% for LPS and 19.2% for LPT (p = 0.33). Two anastomotic leaks occurred in each group. The mean postoperative hospital stay was 9.6 days (standard deviation [SD], 2.6) for LPS and 11.0 days (SD, 5.2) for LPT (p = 0.68). Recovery of postoperative physical performance and social life occurred earlier in the LPS than the LPT group (p < 0.001). At 1-year follow-up, no difference was found in terms of cancer recurrence or long-term complications. CONCLUSION: Oncologic results and postoperative morbidity were comparable for LPS and LPT. LPS allows a faster postoperative recovery.
BACKGROUND: Thorough training is essential to the success of colorectal laparoscopic surgery (LPS). The aim of this study was to evaluate the results of a 3-month training period in LPS. METHODS: Before beginning the study, the surgical team attended several courses of LPS and spent a long time working at a large animal facility to perfect laparoscopic techniques. Twenty-six consecutive patients underwent LPS in a 3-month training period. Controls (n = 26) who underwent open colorectal surgery (LPT) were selected to match the LPSpatients for age, gender, primary disease, type of surgery, comorbidity, and nutritional status. RESULTS: Conversion to open surgery was necessary in one patient (3.8%). The operative time was 1 h longer for LPS than LPT (p < 0.001). The mean number of lymph nodes harvested was 17 in LPS and 18 in LPT (p = 0.76). The first flatus (p < 0.02) and bowel movement (p < 0.002) occurred earlier in the LPS group. The postoperative infection rate was 11.5% for LPS and 19.2% for LPT (p = 0.33). Two anastomotic leaks occurred in each group. The mean postoperative hospital stay was 9.6 days (standard deviation [SD], 2.6) for LPS and 11.0 days (SD, 5.2) for LPT (p = 0.68). Recovery of postoperative physical performance and social life occurred earlier in the LPS than the LPT group (p < 0.001). At 1-year follow-up, no difference was found in terms of cancer recurrence or long-term complications. CONCLUSION: Oncologic results and postoperative morbidity were comparable for LPS and LPT. LPS allows a faster postoperative recovery.
Authors: Marco Braga; Andrea Vignali; Luca Gianotti; Walter Zuliani; Giovanni Radaelli; Paola Gruarin; Paolo Dellabona; Valerio Di Carlo Journal: Ann Surg Date: 2002-12 Impact factor: 12.969
Authors: Marco Braga; Andrea Vignali; Walter Zuliani; Matteo Frasson; Clelia Di Serio; Valerio Di Carlo Journal: Ann Surg Date: 2005-12 Impact factor: 12.969
Authors: Andrea Vignali; Paola De Nardi; Luca Ghirardelli; Saverio Di Palo; Carlo Staudacher Journal: World J Gastroenterol Date: 2013-11-14 Impact factor: 5.742
Authors: Marco Braga; Nicolò Pecorelli; Matteo Frasson; Andrea Vignali; Walter Zuliani; Valerio Di Carlo Journal: World J Gastrointest Oncol Date: 2011-03-15