Laparoscopic colectomy: indications, standardized technique and results after 6 years experience.
Hepatogastroenterology
; 47(33): 683-91, 2000.
Article
em En
| MEDLINE
| ID: mdl-10919012
ABSTRACT
BACKGROUND/AIMS:
The aim of the present study was to perform a retrospective study of our experience in performing laparoscopic colon surgery after 6 years experience.METHODOLOGY:
From April 1992 to April 1998, 215 patients underwent colon laparoscopic surgery. There were 121 females and 94 males, whose average age was 66.7 (range 31-92).RESULTS:
170 laparoscopic procedures were completed out of 215 (79%) 151 resections (22 for a benign lesion and 129 for a malignant one), 4 reversal of Hartmann's procedures, 6 rectopexy, 3 ileotransverstomies and 6 suture of traumatic colon perforation. There were 3 mortalities out of 215 (1.9%). The conversions were 45 out of 215 (20.9%); 22 (10.2%) cases were, however, converted to a laparoscopic facilitated procedure. The most common causes for conversion were the presence of bulky tumors and/or tumors that contaminated the adjacent structures (16/215), adhesions due to previous operations (9/215) and the patient's obesity (8/215). There were 39 complications (18.1%), 10 (4.6%) out of which required reoperation (2 anastomotic fistula, 2 anastomotic leak, 2 anastomotic stenosis, 2 hemorrhage, 1 colic iatrogenic perforation and 1 occlusion to rotation of anastomosis). There were only 2 recurrences (1.3%), 15 months (C2) and 8 months (B2) after the operation for intraoperative technical error. The average number of lymph nodes harvested in resected specimens was 12.8 (range 1-41), whereas the mean distance of the tumor from the proximal margin of resection was 11.5 cm (range 5-35), and from the distal margin 7.5 cm (range 1-25). The average operative time was 165 min (range 40-360), and the mean hospital stay was 9.2 days (range 6-40).CONCLUSIONS:
A colon resection for a malignant lesion, if performed with the highest respect for the oncologic principles, proves that it is impossible to develop a wall and intraluminal recurrence, which, in our opinion, may be caused by an improper surgical technique. Therefore, neoplastic colon laparoscopic surgery must be the perogative of a few selected and specialized centers.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Laparoscopia
/
Colectomia
/
Doenças do Colo
/
Neoplasias do Colo
Tipo de estudo:
Observational_studies
Limite:
Adult
/
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Hepatogastroenterology
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Itália