Evolution of Technique in Performance of Minimally Invasive Colectomies
BACKGROUND:Hand-assisted laparoscopic surgery is commonly used in colorectal surgery and provides benefit in complex cases. OBJECTIVE:This study examined the minimally invasive surgical trends, patient characteristics, and operative variables unique to patients undergoing hand-assisted laparoscopic...
Gespeichert in:
| Veröffentlicht in: | Diseases of the colon & rectum 2014-09, Vol.57 (9), p.1090-1097 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1097 |
|---|---|
| container_issue | 9 |
| container_start_page | 1090 |
| container_title | Diseases of the colon & rectum |
| container_volume | 57 |
| creator | Jadlowiec, Caroline C Mannion, Elizabeth M Thielman, Mary J Bartus, Christine M Johnson, Kristina H Sardella, William V Vignati, Paul V Cohen, Jeffrey L |
| description | BACKGROUND:Hand-assisted laparoscopic surgery is commonly used in colorectal surgery and provides benefit in complex cases.
OBJECTIVE:This study examined the minimally invasive surgical trends, patient characteristics, and operative variables unique to patients undergoing hand-assisted laparoscopic surgery.
DESIGN:This was a retrospective medical chart review.
SETTINGS:The study was conducted in a tertiary care medical center.
PATIENTS:Patients included in the study were those who underwent pure laparoscopic colectomies, hand-assisted laparoscopic colectomies, and traditional open surgery for elective treatment of diverticular disease, colorectal cancer, IBD, and benign polyp disease.
MAIN OUTCOME MEASURES:Primary outcomes included patient characteristics and operative variables unique to patients undergoing hand-assisted laparoscopic surgery and documentation of operative technique trends within an experienced colorectal group.
RESULTS:Diverticular disease characteristics specific to hand-assisted laparoscopic surgery included the presence of dense inflammatory adhesions (p < 0.0001), diverticular fistulas (p < 0.0001), and unresolved phlegmon (p = 0.0003). Characteristics specific for colorectal cancer included intraoperative tumor bulk (p < 0.0001) and the inability to achieve appropriate surgical resection margins (p < 0.001). Similarly, variables identified for benign polyp disease included adhesions (p < 0.0001) and the ability to gain adequate exposure (p < 0.0001). Limited use of hand-assisted laparoscopic surgery was observed in patients with IBD.
LIMITATIONS:This was a retrospective, observational study from a single center.
CONCLUSIONS:Conversion to hand-assisted laparoscopic surgery provides benefit in surgical scenarios where dense inflammatory adhesions, diverticular fistulas, and intra-abdominal postdiverticulitis phlegmon are present. In addition, benefit is observed in patients with colorectal cancer where laparoscopic dissection of bulky tumor proves to be difficult and where the technical ability to obtain margins using pure laparoscopy is compromised. Although our practice has changed to favor pure laparoscopy, hand-assisted laparoscopic surgery continues to play an important role in complex colorectal cases that otherwise would require open surgery (see video, Supplemental Digital Content 1, http://links.lww.com/DCR/A146). |
| doi_str_mv | 10.1097/DCR.0000000000000178 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1552373428</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1552373428</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3826-cdd4737091d5aa292bbe7df263a3d819ad9e0aa4a1e67483d48db7326da9ea483</originalsourceid><addsrcrecordid>eNpdkElPwzAQhS0EgrL8A4RyQeIS8JLYyRGVVQKBUDlH03iiGpwY7KQV_x6XlkX4Ys3zm3njj5BDRk8ZLdXZxfjplP49TBUbZMRyQVMq8mKTjKLGU6Go3CG7IbzEknKqtskOzxllkuYjcn05d3bojesS1yQTrGedeR8wMV3yiL5xvoWuxuXbvelMC9Z-JLfdHIKZYzJ2FuvetQbDPtlqwAY8WN975PnqcjK-Se8erm_H53dpLQou01rrTMWNSqZzAF7y6RSVbrgUIHTBStAlUoAMGEqVFUJnhZ4qwaWGEiEKe-RkNffNu7hn6KvWhBqthQ7dECqW51wokfGlNVtZa-9C8NhUbz7-wH9UjFZLhFVEWP1HGNuO1gnDtEX90_TNLBqO1wYINdjGR0Im_PoKJQWV9Dd_4WyPPrzaYYG-miHYfvaVK7JcpJyyjJaxSpeSFJ9SMIf_</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1552373428</pqid></control><display><type>article</type><title>Evolution of Technique in Performance of Minimally Invasive Colectomies</title><source>MEDLINE</source><source>Journals@Ovid Complete</source><creator>Jadlowiec, Caroline C ; Mannion, Elizabeth M ; Thielman, Mary J ; Bartus, Christine M ; Johnson, Kristina H ; Sardella, William V ; Vignati, Paul V ; Cohen, Jeffrey L</creator><creatorcontrib>Jadlowiec, Caroline C ; Mannion, Elizabeth M ; Thielman, Mary J ; Bartus, Christine M ; Johnson, Kristina H ; Sardella, William V ; Vignati, Paul V ; Cohen, Jeffrey L</creatorcontrib><description><![CDATA[BACKGROUND:Hand-assisted laparoscopic surgery is commonly used in colorectal surgery and provides benefit in complex cases.
OBJECTIVE:This study examined the minimally invasive surgical trends, patient characteristics, and operative variables unique to patients undergoing hand-assisted laparoscopic surgery.
DESIGN:This was a retrospective medical chart review.
SETTINGS:The study was conducted in a tertiary care medical center.
PATIENTS:Patients included in the study were those who underwent pure laparoscopic colectomies, hand-assisted laparoscopic colectomies, and traditional open surgery for elective treatment of diverticular disease, colorectal cancer, IBD, and benign polyp disease.
MAIN OUTCOME MEASURES:Primary outcomes included patient characteristics and operative variables unique to patients undergoing hand-assisted laparoscopic surgery and documentation of operative technique trends within an experienced colorectal group.
RESULTS:Diverticular disease characteristics specific to hand-assisted laparoscopic surgery included the presence of dense inflammatory adhesions (p < 0.0001), diverticular fistulas (p < 0.0001), and unresolved phlegmon (p = 0.0003). Characteristics specific for colorectal cancer included intraoperative tumor bulk (p < 0.0001) and the inability to achieve appropriate surgical resection margins (p < 0.001). Similarly, variables identified for benign polyp disease included adhesions (p < 0.0001) and the ability to gain adequate exposure (p < 0.0001). Limited use of hand-assisted laparoscopic surgery was observed in patients with IBD.
LIMITATIONS:This was a retrospective, observational study from a single center.
CONCLUSIONS:Conversion to hand-assisted laparoscopic surgery provides benefit in surgical scenarios where dense inflammatory adhesions, diverticular fistulas, and intra-abdominal postdiverticulitis phlegmon are present. In addition, benefit is observed in patients with colorectal cancer where laparoscopic dissection of bulky tumor proves to be difficult and where the technical ability to obtain margins using pure laparoscopy is compromised. Although our practice has changed to favor pure laparoscopy, hand-assisted laparoscopic surgery continues to play an important role in complex colorectal cases that otherwise would require open surgery (see video, Supplemental Digital Content 1, http://links.lww.com/DCR/A146).]]></description><identifier>ISSN: 0012-3706</identifier><identifier>EISSN: 1530-0358</identifier><identifier>DOI: 10.1097/DCR.0000000000000178</identifier><identifier>PMID: 25101605</identifier><identifier>CODEN: DICRAG</identifier><language>eng</language><publisher>Hagerstown, MDc: The American Society of Colon and Rectal Surgeons</publisher><subject>Biological and medical sciences ; Clinical Competence ; Colectomy - methods ; Colonic Polyps - surgery ; Colorectal Neoplasms - surgery ; Colorectal Surgery - methods ; Diverticulum, Colon - surgery ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hand-Assisted Laparoscopy ; Humans ; Irritable Bowel Syndrome - surgery ; Male ; Medical sciences ; Middle Aged ; Orthopedic surgery ; Retrospective Studies ; Stomach, duodenum, intestine, rectum, anus ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the digestive system ; Treatment Outcome</subject><ispartof>Diseases of the colon & rectum, 2014-09, Vol.57 (9), p.1090-1097</ispartof><rights>2014 The American Society of Colon and Rectal Surgeons</rights><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3826-cdd4737091d5aa292bbe7df263a3d819ad9e0aa4a1e67483d48db7326da9ea483</citedby><cites>FETCH-LOGICAL-c3826-cdd4737091d5aa292bbe7df263a3d819ad9e0aa4a1e67483d48db7326da9ea483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=28763060$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25101605$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jadlowiec, Caroline C</creatorcontrib><creatorcontrib>Mannion, Elizabeth M</creatorcontrib><creatorcontrib>Thielman, Mary J</creatorcontrib><creatorcontrib>Bartus, Christine M</creatorcontrib><creatorcontrib>Johnson, Kristina H</creatorcontrib><creatorcontrib>Sardella, William V</creatorcontrib><creatorcontrib>Vignati, Paul V</creatorcontrib><creatorcontrib>Cohen, Jeffrey L</creatorcontrib><title>Evolution of Technique in Performance of Minimally Invasive Colectomies</title><title>Diseases of the colon & rectum</title><addtitle>Dis Colon Rectum</addtitle><description><![CDATA[BACKGROUND:Hand-assisted laparoscopic surgery is commonly used in colorectal surgery and provides benefit in complex cases.
OBJECTIVE:This study examined the minimally invasive surgical trends, patient characteristics, and operative variables unique to patients undergoing hand-assisted laparoscopic surgery.
DESIGN:This was a retrospective medical chart review.
SETTINGS:The study was conducted in a tertiary care medical center.
PATIENTS:Patients included in the study were those who underwent pure laparoscopic colectomies, hand-assisted laparoscopic colectomies, and traditional open surgery for elective treatment of diverticular disease, colorectal cancer, IBD, and benign polyp disease.
MAIN OUTCOME MEASURES:Primary outcomes included patient characteristics and operative variables unique to patients undergoing hand-assisted laparoscopic surgery and documentation of operative technique trends within an experienced colorectal group.
RESULTS:Diverticular disease characteristics specific to hand-assisted laparoscopic surgery included the presence of dense inflammatory adhesions (p < 0.0001), diverticular fistulas (p < 0.0001), and unresolved phlegmon (p = 0.0003). Characteristics specific for colorectal cancer included intraoperative tumor bulk (p < 0.0001) and the inability to achieve appropriate surgical resection margins (p < 0.001). Similarly, variables identified for benign polyp disease included adhesions (p < 0.0001) and the ability to gain adequate exposure (p < 0.0001). Limited use of hand-assisted laparoscopic surgery was observed in patients with IBD.
LIMITATIONS:This was a retrospective, observational study from a single center.
CONCLUSIONS:Conversion to hand-assisted laparoscopic surgery provides benefit in surgical scenarios where dense inflammatory adhesions, diverticular fistulas, and intra-abdominal postdiverticulitis phlegmon are present. In addition, benefit is observed in patients with colorectal cancer where laparoscopic dissection of bulky tumor proves to be difficult and where the technical ability to obtain margins using pure laparoscopy is compromised. Although our practice has changed to favor pure laparoscopy, hand-assisted laparoscopic surgery continues to play an important role in complex colorectal cases that otherwise would require open surgery (see video, Supplemental Digital Content 1, http://links.lww.com/DCR/A146).]]></description><subject>Biological and medical sciences</subject><subject>Clinical Competence</subject><subject>Colectomy - methods</subject><subject>Colonic Polyps - surgery</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Colorectal Surgery - methods</subject><subject>Diverticulum, Colon - surgery</subject><subject>Female</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hand-Assisted Laparoscopy</subject><subject>Humans</subject><subject>Irritable Bowel Syndrome - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Orthopedic surgery</subject><subject>Retrospective Studies</subject><subject>Stomach, duodenum, intestine, rectum, anus</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the digestive system</subject><subject>Treatment Outcome</subject><issn>0012-3706</issn><issn>1530-0358</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkElPwzAQhS0EgrL8A4RyQeIS8JLYyRGVVQKBUDlH03iiGpwY7KQV_x6XlkX4Ys3zm3njj5BDRk8ZLdXZxfjplP49TBUbZMRyQVMq8mKTjKLGU6Go3CG7IbzEknKqtskOzxllkuYjcn05d3bojesS1yQTrGedeR8wMV3yiL5xvoWuxuXbvelMC9Z-JLfdHIKZYzJ2FuvetQbDPtlqwAY8WN975PnqcjK-Se8erm_H53dpLQou01rrTMWNSqZzAF7y6RSVbrgUIHTBStAlUoAMGEqVFUJnhZ4qwaWGEiEKe-RkNffNu7hn6KvWhBqthQ7dECqW51wokfGlNVtZa-9C8NhUbz7-wH9UjFZLhFVEWP1HGNuO1gnDtEX90_TNLBqO1wYINdjGR0Im_PoKJQWV9Dd_4WyPPrzaYYG-miHYfvaVK7JcpJyyjJaxSpeSFJ9SMIf_</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>Jadlowiec, Caroline C</creator><creator>Mannion, Elizabeth M</creator><creator>Thielman, Mary J</creator><creator>Bartus, Christine M</creator><creator>Johnson, Kristina H</creator><creator>Sardella, William V</creator><creator>Vignati, Paul V</creator><creator>Cohen, Jeffrey L</creator><general>The American Society of Colon and Rectal Surgeons</general><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Evolution of Technique in Performance of Minimally Invasive Colectomies</title><author>Jadlowiec, Caroline C ; Mannion, Elizabeth M ; Thielman, Mary J ; Bartus, Christine M ; Johnson, Kristina H ; Sardella, William V ; Vignati, Paul V ; Cohen, Jeffrey L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3826-cdd4737091d5aa292bbe7df263a3d819ad9e0aa4a1e67483d48db7326da9ea483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Biological and medical sciences</topic><topic>Clinical Competence</topic><topic>Colectomy - methods</topic><topic>Colonic Polyps - surgery</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Colorectal Surgery - methods</topic><topic>Diverticulum, Colon - surgery</topic><topic>Female</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>Hand-Assisted Laparoscopy</topic><topic>Humans</topic><topic>Irritable Bowel Syndrome - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Orthopedic surgery</topic><topic>Retrospective Studies</topic><topic>Stomach, duodenum, intestine, rectum, anus</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the digestive system</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jadlowiec, Caroline C</creatorcontrib><creatorcontrib>Mannion, Elizabeth M</creatorcontrib><creatorcontrib>Thielman, Mary J</creatorcontrib><creatorcontrib>Bartus, Christine M</creatorcontrib><creatorcontrib>Johnson, Kristina H</creatorcontrib><creatorcontrib>Sardella, William V</creatorcontrib><creatorcontrib>Vignati, Paul V</creatorcontrib><creatorcontrib>Cohen, Jeffrey L</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the colon & rectum</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jadlowiec, Caroline C</au><au>Mannion, Elizabeth M</au><au>Thielman, Mary J</au><au>Bartus, Christine M</au><au>Johnson, Kristina H</au><au>Sardella, William V</au><au>Vignati, Paul V</au><au>Cohen, Jeffrey L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution of Technique in Performance of Minimally Invasive Colectomies</atitle><jtitle>Diseases of the colon & rectum</jtitle><addtitle>Dis Colon Rectum</addtitle><date>2014-09</date><risdate>2014</risdate><volume>57</volume><issue>9</issue><spage>1090</spage><epage>1097</epage><pages>1090-1097</pages><issn>0012-3706</issn><eissn>1530-0358</eissn><coden>DICRAG</coden><abstract><![CDATA[BACKGROUND:Hand-assisted laparoscopic surgery is commonly used in colorectal surgery and provides benefit in complex cases.
OBJECTIVE:This study examined the minimally invasive surgical trends, patient characteristics, and operative variables unique to patients undergoing hand-assisted laparoscopic surgery.
DESIGN:This was a retrospective medical chart review.
SETTINGS:The study was conducted in a tertiary care medical center.
PATIENTS:Patients included in the study were those who underwent pure laparoscopic colectomies, hand-assisted laparoscopic colectomies, and traditional open surgery for elective treatment of diverticular disease, colorectal cancer, IBD, and benign polyp disease.
MAIN OUTCOME MEASURES:Primary outcomes included patient characteristics and operative variables unique to patients undergoing hand-assisted laparoscopic surgery and documentation of operative technique trends within an experienced colorectal group.
RESULTS:Diverticular disease characteristics specific to hand-assisted laparoscopic surgery included the presence of dense inflammatory adhesions (p < 0.0001), diverticular fistulas (p < 0.0001), and unresolved phlegmon (p = 0.0003). Characteristics specific for colorectal cancer included intraoperative tumor bulk (p < 0.0001) and the inability to achieve appropriate surgical resection margins (p < 0.001). Similarly, variables identified for benign polyp disease included adhesions (p < 0.0001) and the ability to gain adequate exposure (p < 0.0001). Limited use of hand-assisted laparoscopic surgery was observed in patients with IBD.
LIMITATIONS:This was a retrospective, observational study from a single center.
CONCLUSIONS:Conversion to hand-assisted laparoscopic surgery provides benefit in surgical scenarios where dense inflammatory adhesions, diverticular fistulas, and intra-abdominal postdiverticulitis phlegmon are present. In addition, benefit is observed in patients with colorectal cancer where laparoscopic dissection of bulky tumor proves to be difficult and where the technical ability to obtain margins using pure laparoscopy is compromised. Although our practice has changed to favor pure laparoscopy, hand-assisted laparoscopic surgery continues to play an important role in complex colorectal cases that otherwise would require open surgery (see video, Supplemental Digital Content 1, http://links.lww.com/DCR/A146).]]></abstract><cop>Hagerstown, MDc</cop><pub>The American Society of Colon and Rectal Surgeons</pub><pmid>25101605</pmid><doi>10.1097/DCR.0000000000000178</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0012-3706 |
| ispartof | Diseases of the colon & rectum, 2014-09, Vol.57 (9), p.1090-1097 |
| issn | 0012-3706 1530-0358 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1552373428 |
| source | MEDLINE; Journals@Ovid Complete |
| subjects | Biological and medical sciences Clinical Competence Colectomy - methods Colonic Polyps - surgery Colorectal Neoplasms - surgery Colorectal Surgery - methods Diverticulum, Colon - surgery Female Gastroenterology. Liver. Pancreas. Abdomen Hand-Assisted Laparoscopy Humans Irritable Bowel Syndrome - surgery Male Medical sciences Middle Aged Orthopedic surgery Retrospective Studies Stomach, duodenum, intestine, rectum, anus Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the digestive system Treatment Outcome |
| title | Evolution of Technique in Performance of Minimally Invasive Colectomies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T10%3A02%3A47IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evolution%20of%20Technique%20in%20Performance%20of%20Minimally%20Invasive%20Colectomies&rft.jtitle=Diseases%20of%20the%20colon%20&%20rectum&rft.au=Jadlowiec,%20Caroline%20C&rft.date=2014-09&rft.volume=57&rft.issue=9&rft.spage=1090&rft.epage=1097&rft.pages=1090-1097&rft.issn=0012-3706&rft.eissn=1530-0358&rft.coden=DICRAG&rft_id=info:doi/10.1097/DCR.0000000000000178&rft_dat=%3Cproquest_cross%3E1552373428%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1552373428&rft_id=info:pmid/25101605&rfr_iscdi=true |