Totally laparoscopic versus laparoscopic-assisted left colectomy for cancer: a retrospective review
Background Laparoscopic left colectomy (LLC) became the standard of care for treating distal transverse and descending colon cancer in many centers. Most centers use laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA). A totally laparoscopic colectomy with intracorporeal anastom...
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| Veröffentlicht in: | Surgical endoscopy 2016-06, Vol.30 (6), p.2481-2488 |
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| description | Background
Laparoscopic left colectomy (LLC) became the standard of care for treating distal transverse and descending colon cancer in many centers. Most centers use laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA). A totally laparoscopic colectomy with intracorporeal anastomosis (TLC/IA) has been proposed. The purpose of our study is to compare these two techniques.
Methods
A series of 52 patients undergoing LLC for left-sided colon cancer was retrospectively evaluated. Thirty-three patients underwent TLC/IA, and 19 underwent LAC/EA. The following data were collected: gender, age, body mass index, American Society of Anesthesiologists risk class, operation duration, conversion to laparotomy, intraoperative complications, postoperative complications, postoperative course (duration of stay, time to first flatus), number of excised lymph nodes, readmission, and reoperation rates. Data were prospectively recorded in a colorectal cancer database and retrospectively analyzed.
Results
The only demographic parameter that differed significantly between the groups was age (64.2 ± 12.4 years for the TLC/IA group, vs. 72.7 ± 2.1 years for LAC/EA,
p
= 0.0116). The mini-laparotomy incision was significantly shorter in the TLC/IA than in the LAC/EA group (5.8 ± 0.9 vs. 8.2 ± 0.9 cm, respectively,
p
|
| doi_str_mv | 10.1007/s00464-015-4502-5 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1793568626</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1793568626</sourcerecordid><originalsourceid>FETCH-LOGICAL-c372t-deea4c90fb431bd598c51fab57ebe8b4e1e443cf5e2857fd5babfc4deadebfde3</originalsourceid><addsrcrecordid>eNp1kUtLAzEUhYMotlZ_gBsZcOMmmuc83EnxBQU3dR2SzI1MmTZjMlPpvzelVVRwFZL7nXPvzUHonJJrSkhxEwkRucCESiwkYVgeoDEVnGHGaHmIxqTiBLOiEiN0EuOCJLyi8hiNWM65JIUcIzv3vW7bTdbqTgcfre8am60hxCH-esM6xib2UGctuD6zvgXb--Umcz5kVq8shNtMZwH6pOhSrVlDuq0b-DhFR063Ec725wS9PtzPp0949vL4PL2bYcsL1uMaQAtbEWcEp6aWVWklddrIAgyURgAFIbh1ElgpC1dLo42zogZdg3E18Am62vl2wb8PEHu1bKKFttUr8ENUtKi4zMs8bT9Bl3_QhR_CKk23pVhBciFYouiOsmmnGMCpLjRLHTaKErVNQO0SUCkBtU1AyaS52DsPZgn1t-LryxPAdkBMpdUbhB-t_3X9BGVmlHw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1792706442</pqid></control><display><type>article</type><title>Totally laparoscopic versus laparoscopic-assisted left colectomy for cancer: a retrospective review</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Swaid, Forat ; Sroka, Gideon ; Madi, Hussam ; Shteinberg, Dan ; Somri, Mustafa ; Matter, Ibrahim</creator><creatorcontrib>Swaid, Forat ; Sroka, Gideon ; Madi, Hussam ; Shteinberg, Dan ; Somri, Mustafa ; Matter, Ibrahim</creatorcontrib><description>Background
Laparoscopic left colectomy (LLC) became the standard of care for treating distal transverse and descending colon cancer in many centers. Most centers use laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA). A totally laparoscopic colectomy with intracorporeal anastomosis (TLC/IA) has been proposed. The purpose of our study is to compare these two techniques.
Methods
A series of 52 patients undergoing LLC for left-sided colon cancer was retrospectively evaluated. Thirty-three patients underwent TLC/IA, and 19 underwent LAC/EA. The following data were collected: gender, age, body mass index, American Society of Anesthesiologists risk class, operation duration, conversion to laparotomy, intraoperative complications, postoperative complications, postoperative course (duration of stay, time to first flatus), number of excised lymph nodes, readmission, and reoperation rates. Data were prospectively recorded in a colorectal cancer database and retrospectively analyzed.
Results
The only demographic parameter that differed significantly between the groups was age (64.2 ± 12.4 years for the TLC/IA group, vs. 72.7 ± 2.1 years for LAC/EA,
p
= 0.0116). The mini-laparotomy incision was significantly shorter in the TLC/IA than in the LAC/EA group (5.8 ± 0.9 vs. 8.2 ± 0.9 cm, respectively,
p
< 0.00001). Hospital stay duration was shorter in the TLC/IA group (4.2 ± 1.2 vs. 6.3 ± 1.9,
p
= 0.0001). The average number of harvested lymph nodes did not differ significantly between the groups (12.9 ± 5.7 in TLC/IA vs. 11.2 ± 4.2 in LAC/EA,
p
= 0.2546). No significant differences between the groups were observed in any other perioperative or surgical outcome parameters.
Conclusions
TLC/IA in LLC for the treatment of left colon cancer is technically feasible and can be performed with a low complication rate, favorable cosmetics, and possibly shorter hospital stay, without significantly lengthening operative duration or compromising oncologic radicality principles. Although further prospective randomized studies are needed to determine its role and limitations, we encourage using it as an alternative to LAC/EA in LLC.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-015-4502-5</identifier><identifier>PMID: 26335075</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aged ; Body mass index ; Colectomy - methods ; Colonic Neoplasms - surgery ; Colorectal cancer ; Disease prevention ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Hospitals ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Node Excision ; Lymphatic system ; Male ; Medical personnel ; Medicine ; Medicine & Public Health ; Middle Aged ; Proctology ; Retrospective Studies ; Surgery ; Surgical anastomosis ; Tattoos</subject><ispartof>Surgical endoscopy, 2016-06, Vol.30 (6), p.2481-2488</ispartof><rights>Springer Science+Business Media New York 2015</rights><rights>Springer Science+Business Media New York 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-deea4c90fb431bd598c51fab57ebe8b4e1e443cf5e2857fd5babfc4deadebfde3</citedby><cites>FETCH-LOGICAL-c372t-deea4c90fb431bd598c51fab57ebe8b4e1e443cf5e2857fd5babfc4deadebfde3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-015-4502-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-015-4502-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26335075$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Swaid, Forat</creatorcontrib><creatorcontrib>Sroka, Gideon</creatorcontrib><creatorcontrib>Madi, Hussam</creatorcontrib><creatorcontrib>Shteinberg, Dan</creatorcontrib><creatorcontrib>Somri, Mustafa</creatorcontrib><creatorcontrib>Matter, Ibrahim</creatorcontrib><title>Totally laparoscopic versus laparoscopic-assisted left colectomy for cancer: a retrospective review</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Background
Laparoscopic left colectomy (LLC) became the standard of care for treating distal transverse and descending colon cancer in many centers. Most centers use laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA). A totally laparoscopic colectomy with intracorporeal anastomosis (TLC/IA) has been proposed. The purpose of our study is to compare these two techniques.
Methods
A series of 52 patients undergoing LLC for left-sided colon cancer was retrospectively evaluated. Thirty-three patients underwent TLC/IA, and 19 underwent LAC/EA. The following data were collected: gender, age, body mass index, American Society of Anesthesiologists risk class, operation duration, conversion to laparotomy, intraoperative complications, postoperative complications, postoperative course (duration of stay, time to first flatus), number of excised lymph nodes, readmission, and reoperation rates. Data were prospectively recorded in a colorectal cancer database and retrospectively analyzed.
Results
The only demographic parameter that differed significantly between the groups was age (64.2 ± 12.4 years for the TLC/IA group, vs. 72.7 ± 2.1 years for LAC/EA,
p
= 0.0116). The mini-laparotomy incision was significantly shorter in the TLC/IA than in the LAC/EA group (5.8 ± 0.9 vs. 8.2 ± 0.9 cm, respectively,
p
< 0.00001). Hospital stay duration was shorter in the TLC/IA group (4.2 ± 1.2 vs. 6.3 ± 1.9,
p
= 0.0001). The average number of harvested lymph nodes did not differ significantly between the groups (12.9 ± 5.7 in TLC/IA vs. 11.2 ± 4.2 in LAC/EA,
p
= 0.2546). No significant differences between the groups were observed in any other perioperative or surgical outcome parameters.
Conclusions
TLC/IA in LLC for the treatment of left colon cancer is technically feasible and can be performed with a low complication rate, favorable cosmetics, and possibly shorter hospital stay, without significantly lengthening operative duration or compromising oncologic radicality principles. Although further prospective randomized studies are needed to determine its role and limitations, we encourage using it as an alternative to LAC/EA in LLC.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Body mass index</subject><subject>Colectomy - methods</subject><subject>Colonic Neoplasms - surgery</subject><subject>Colorectal cancer</subject><subject>Disease prevention</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparotomy</subject><subject>Length of Stay</subject><subject>Lymph Node Excision</subject><subject>Lymphatic system</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Proctology</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Surgical anastomosis</subject><subject>Tattoos</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUtLAzEUhYMotlZ_gBsZcOMmmuc83EnxBQU3dR2SzI1MmTZjMlPpvzelVVRwFZL7nXPvzUHonJJrSkhxEwkRucCESiwkYVgeoDEVnGHGaHmIxqTiBLOiEiN0EuOCJLyi8hiNWM65JIUcIzv3vW7bTdbqTgcfre8am60hxCH-esM6xib2UGctuD6zvgXb--Umcz5kVq8shNtMZwH6pOhSrVlDuq0b-DhFR063Ec725wS9PtzPp0949vL4PL2bYcsL1uMaQAtbEWcEp6aWVWklddrIAgyURgAFIbh1ElgpC1dLo42zogZdg3E18Am62vl2wb8PEHu1bKKFttUr8ENUtKi4zMs8bT9Bl3_QhR_CKk23pVhBciFYouiOsmmnGMCpLjRLHTaKErVNQO0SUCkBtU1AyaS52DsPZgn1t-LryxPAdkBMpdUbhB-t_3X9BGVmlHw</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Swaid, Forat</creator><creator>Sroka, Gideon</creator><creator>Madi, Hussam</creator><creator>Shteinberg, Dan</creator><creator>Somri, Mustafa</creator><creator>Matter, Ibrahim</creator><general>Springer US</general><general>Springer Nature B.V</general><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>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20160601</creationdate><title>Totally laparoscopic versus laparoscopic-assisted left colectomy for cancer: a retrospective review</title><author>Swaid, Forat ; Sroka, Gideon ; Madi, Hussam ; Shteinberg, Dan ; Somri, Mustafa ; Matter, Ibrahim</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-deea4c90fb431bd598c51fab57ebe8b4e1e443cf5e2857fd5babfc4deadebfde3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Body mass index</topic><topic>Colectomy - methods</topic><topic>Colonic Neoplasms - surgery</topic><topic>Colorectal cancer</topic><topic>Disease prevention</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparotomy</topic><topic>Length of Stay</topic><topic>Lymph Node Excision</topic><topic>Lymphatic system</topic><topic>Male</topic><topic>Medical personnel</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Proctology</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Surgical anastomosis</topic><topic>Tattoos</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Swaid, Forat</creatorcontrib><creatorcontrib>Sroka, Gideon</creatorcontrib><creatorcontrib>Madi, Hussam</creatorcontrib><creatorcontrib>Shteinberg, Dan</creatorcontrib><creatorcontrib>Somri, Mustafa</creatorcontrib><creatorcontrib>Matter, Ibrahim</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Proquest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Swaid, Forat</au><au>Sroka, Gideon</au><au>Madi, Hussam</au><au>Shteinberg, Dan</au><au>Somri, Mustafa</au><au>Matter, Ibrahim</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Totally laparoscopic versus laparoscopic-assisted left colectomy for cancer: a retrospective review</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>30</volume><issue>6</issue><spage>2481</spage><epage>2488</epage><pages>2481-2488</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Background
Laparoscopic left colectomy (LLC) became the standard of care for treating distal transverse and descending colon cancer in many centers. Most centers use laparoscopic-assisted colectomy with extracorporeal anastomosis (LAC/EA). A totally laparoscopic colectomy with intracorporeal anastomosis (TLC/IA) has been proposed. The purpose of our study is to compare these two techniques.
Methods
A series of 52 patients undergoing LLC for left-sided colon cancer was retrospectively evaluated. Thirty-three patients underwent TLC/IA, and 19 underwent LAC/EA. The following data were collected: gender, age, body mass index, American Society of Anesthesiologists risk class, operation duration, conversion to laparotomy, intraoperative complications, postoperative complications, postoperative course (duration of stay, time to first flatus), number of excised lymph nodes, readmission, and reoperation rates. Data were prospectively recorded in a colorectal cancer database and retrospectively analyzed.
Results
The only demographic parameter that differed significantly between the groups was age (64.2 ± 12.4 years for the TLC/IA group, vs. 72.7 ± 2.1 years for LAC/EA,
p
= 0.0116). The mini-laparotomy incision was significantly shorter in the TLC/IA than in the LAC/EA group (5.8 ± 0.9 vs. 8.2 ± 0.9 cm, respectively,
p
< 0.00001). Hospital stay duration was shorter in the TLC/IA group (4.2 ± 1.2 vs. 6.3 ± 1.9,
p
= 0.0001). The average number of harvested lymph nodes did not differ significantly between the groups (12.9 ± 5.7 in TLC/IA vs. 11.2 ± 4.2 in LAC/EA,
p
= 0.2546). No significant differences between the groups were observed in any other perioperative or surgical outcome parameters.
Conclusions
TLC/IA in LLC for the treatment of left colon cancer is technically feasible and can be performed with a low complication rate, favorable cosmetics, and possibly shorter hospital stay, without significantly lengthening operative duration or compromising oncologic radicality principles. Although further prospective randomized studies are needed to determine its role and limitations, we encourage using it as an alternative to LAC/EA in LLC.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26335075</pmid><doi>10.1007/s00464-015-4502-5</doi><tpages>8</tpages></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Surgery Aged Body mass index Colectomy - methods Colonic Neoplasms - surgery Colorectal cancer Disease prevention Female Gastroenterology Gynecology Hepatology Hospitals Humans Laparoscopy Laparotomy Length of Stay Lymph Node Excision Lymphatic system Male Medical personnel Medicine Medicine & Public Health Middle Aged Proctology Retrospective Studies Surgery Surgical anastomosis Tattoos |
| title | Totally laparoscopic versus laparoscopic-assisted left colectomy for cancer: a retrospective review |
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