Literature DB >> 18831870

From small acorns--developing a laparoscopic colorectal surgical service.

J K Smith1, A G Acheson, J A D Simpson, J Stewart, I J Beckingham, C B Gornall, J P Williams, M H Robinson, C A Maxwell-Armstrong.   

Abstract

INTRODUCTION: Randomised controlled trials have shown that laparoscopic colorectal surgery is equal in terms of safety to open surgery. Benefits have been seen for length of stay, blood loss, immune suppression and analgesia requirements. The aim of this study was to assess the safety and feasibility of introducing laparoscopic colorectal surgery to our unit. PATIENTS AND METHODS: Prospectively collected cases of all patients undergoing laparoscopic colorectal surgery between July 2003 and July 2007 were reviewed.
RESULTS: A total of 143 patients (75 males and 68 females) with a mean age of 65.8 years (range, 21-95 years) underwent surgery. Laparoscopic resection for colorectal malignancy was performed in 93 patients (65%). The conversion rate for all cases was 14.7%. Mean operative time was 203 min (range, 100-400 min), with a mean blood loss of 180 ml. The mean number of lymph nodes in malignant cases was 13.8 with clear resection margin in all but one case. The mean postoperative stay was 5.6 days (median, 4 days; range, 2-35 days). UKCCR standard for lymph node retrieval was achieved in 62.6% of cases. There were four postoperative deaths. The overall 30-day morbidity rate was 21.7%. The service is consultant-led with 9.8% of cases performed by senior trainees and 37% of procedures performed by two consultants.
CONCLUSIONS: Laparoscopic colorectal surgery is technically feasible and safe in our hands. Although operative time is longer, this is counterbalanced by shorter hospital stay. The results from this series support the findings of others and continuing development of this service.

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Year:  2008        PMID: 18831870      PMCID: PMC2728316          DOI: 10.1308/003588408X318110

Source DB:  PubMed          Journal:  Ann R Coll Surg Engl        ISSN: 0035-8843            Impact factor:   1.891


  18 in total

1.  Ongoing deficits in resident training for minimally invasive surgery.

Authors:  Adrian Park; Donald Witzke; Michael Donnelly
Journal:  J Gastrointest Surg       Date:  2002 May-Jun       Impact factor: 3.452

2.  Evaluation of outcome of laparoscopic colorectal resection with POSSUM, Portsmouth POSSUM and colorectal POSSUM.

Authors:  W L Law; C M Lam; Y M Lee
Journal:  Br J Surg       Date:  2006-01       Impact factor: 6.939

3.  Operative time is a poor surrogate for the learning curve in laparoscopic colorectal surgery.

Authors:  W Chen; E Sailhamer; D L Berger; D W Rattner
Journal:  Surg Endosc       Date:  2006-12-16       Impact factor: 4.584

4.  Early introduction of laparoscopic sigmoid colectomy during residency.

Authors:  S Daetwiler; U Guller; O Schob; M Adamina
Journal:  Br J Surg       Date:  2007-05       Impact factor: 6.939

5.  Incidence of clinical pulmonary embolism after laparoscopic surgery.

Authors:  D T Inderbitzin; I Opitz; U Giger; T Kocher; L Krähenbühl
Journal:  Br J Surg       Date:  2007-05       Impact factor: 6.939

6.  Meta-analysis of non-randomized comparative studies of the short-term outcomes of laparoscopic resection for colorectal cancer.

Authors:  Ned S Abraham; Christopher M Byrne; Jane M Young; Michael J Solomon
Journal:  ANZ J Surg       Date:  2007-07       Impact factor: 1.872

7.  Converted laparoscopic colectomy: what are the consequences?

Authors:  A Belizon; C T Sardinha; M E Sher
Journal:  Surg Endosc       Date:  2006-05-12       Impact factor: 4.584

8.  Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial.

Authors:  Ruben Veldkamp; Esther Kuhry; Wim C J Hop; J Jeekel; G Kazemier; H Jaap Bonjer; Eva Haglind; Lars Påhlman; Miguel A Cuesta; Simon Msika; Mario Morino; Antonio M Lacy
Journal:  Lancet Oncol       Date:  2005-07       Impact factor: 41.316

9.  Importance of conversion for results obtained with laparoscopic colorectal surgery.

Authors:  F Marusch; I Gastinger; C Schneider; H Scheidbach; J Konradt; H P Bruch; L Köhler; E Bärlehner; F Köckerling
Journal:  Dis Colon Rectum       Date:  2001-02       Impact factor: 4.585

10.  Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial.

Authors:  Antonio M Lacy; Juan C García-Valdecasas; Salvadora Delgado; Antoni Castells; Pilar Taurá; Josep M Piqué; Josep Visa
Journal:  Lancet       Date:  2002-06-29       Impact factor: 79.321

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