BACKGROUND: This study examined one surgeon's practice to determine the place of laparoscopic colorectal cancer surgery. METHODS: Some 365 patients undergoing elective colorectal cancer resection (219 colonic, 146 rectal) were studied prospectively. Early (1994-1997; 104 patients), middle (1998-2001; 112) and late (2002-2005; 149) cohorts were analysed with respect to suitability for laparoscopic surgery, conversion and outcome. RESULTS:Forty-six of 135 patients undergoingopen resection were suitable for laparoscopic surgery but randomized to open surgery. The proportion of attempted laparoscopic resections (35.6, 65.2 and 80.6 per cent in early, middle and late cohorts) and patients thought suitable for laparoscopic resection (37.5, 87.5 and 94.0 per cent respectively; P = 0.001) increased over time. Independent predictors of conversion were rectal cancer surgery (odds ratio (OR) 3.12 versus colonic surgery) and body mass index 28 kg/m(2) or more (OR 3.87). Conversion was necessary in all five patients with a threatened margin predicted by preoperative magnetic resonance imaging. After exclusion of these patients the conversion rate in the late cohort was 8.7 per cent. During the same period, inclusion of 20 patients who were suitable for laparoscopic surgery but underwent open resection meant that 135 (90.6 per cent) of 149 patients were actually suitable for laparoscopic resection. CONCLUSION: With experience, laparoscopic surgery is feasible in around 90 per cent of elective colorectal cancer resections. (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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BACKGROUND: This study examined one surgeon's practice to determine the place of laparoscopic colorectal cancer surgery. METHODS: Some 365 patients undergoing elective colorectal cancer resection (219 colonic, 146 rectal) were studied prospectively. Early (1994-1997; 104 patients), middle (1998-2001; 112) and late (2002-2005; 149) cohorts were analysed with respect to suitability for laparoscopic surgery, conversion and outcome. RESULTS: Forty-six of 135 patients undergoing open resection were suitable for laparoscopic surgery but randomized to open surgery. The proportion of attempted laparoscopic resections (35.6, 65.2 and 80.6 per cent in early, middle and late cohorts) and patients thought suitable for laparoscopic resection (37.5, 87.5 and 94.0 per cent respectively; P = 0.001) increased over time. Independent predictors of conversion were rectal cancer surgery (odds ratio (OR) 3.12 versus colonic surgery) and body mass index 28 kg/m(2) or more (OR 3.87). Conversion was necessary in all five patients with a threatened margin predicted by preoperative magnetic resonance imaging. After exclusion of these patients the conversion rate in the late cohort was 8.7 per cent. During the same period, inclusion of 20 patients who were suitable for laparoscopic surgery but underwent open resection meant that 135 (90.6 per cent) of 149 patients were actually suitable for laparoscopic resection. CONCLUSION: With experience, laparoscopic surgery is feasible in around 90 per cent of elective colorectal cancer resections. (c) 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
Authors: Dara O Kavanagh; David Gibson; Diarmaid C Moran; Myles Smith; Kate O Donnell; Emmanuel Eguare; Frank B V Keane; Diarmaid S O Riordain; Paul C Neary Journal: Int J Colorectal Dis Date: 2010-10-23 Impact factor: 2.571
Authors: Giuseppe R Nigri; Alan S Rosman; Niccolò Petrucciani; Alessandro Fancellu; Michele Pisano; Luigi Zorcolo; Giovanni Ramacciato; Marcovalerio Melis Journal: Surg Endosc Date: 2010-12-24 Impact factor: 4.584
Authors: Christopher D Briggs; Christopher D Mann; Glen R B Irving; Christopher P Neal; Mark Peterson; Iain C Cameron; David P Berry Journal: J Gastrointest Surg Date: 2009-01-07 Impact factor: 3.452
Authors: U O Gustafsson; M J Scott; W Schwenk; N Demartines; D Roulin; N Francis; C E McNaught; J Macfie; A S Liberman; M Soop; A Hill; R H Kennedy; D N Lobo; K Fearon; O Ljungqvist Journal: World J Surg Date: 2013-02 Impact factor: 3.352