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Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
Laparoscopic colon resections: a five-year retrospective review
1Department of Surgery, Willis Knighton Hospital and Louisiana State University Medical Center, Shreveport 71130, USA.
The American Surgeon
|April 12, 2000
Summary
Laparoscopic colectomy offers benefits like faster bowel function recovery, reduced hospital stays, and lower costs compared to open surgery. While safe for benign conditions, its use in malignant disease requires further long-term evaluation.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Laparoscopic colectomy is increasingly used for benign conditions, but its application in malignant disease for curative resection faces uncertainties regarding port site metastasis, long-term survival, and resection adequacy.
- While most procedures are technically assisted, a growing trend involves totally laparoscopic colectomies with intracorporeal anastomosis.
Purpose of the Study:
- To review and analyze all laparoscopic colectomies performed at a specific medical center since 1992.
- To compare outcomes between laparoscopic and converted (open) colectomy procedures.
Main Methods:
- Retrospective chart review of 338 patients who underwent colectomies.
- Comparison of laparoscopic colectomy (n=285) versus converted colectomy (n=53) based on age, operative time, hospital stay, bowel function recovery, cost, complication rates, and port site recurrence.
Main Results:
- Laparoscopic colectomy demonstrated a 3-day shorter hospital stay and 1-day earlier return of bowel function.
- Average hospital cost decreased by $5000 with laparoscopic colectomy.
- Complication rates were lower in the laparoscopic group, with port site cancer recurrence (0.7%) not exceeding incisional recurrence in the converted group (1.8%). The conversion rate was 15%.
Conclusions:
- Laparoscopic colectomy offers significant advantages in terms of bowel function recovery, hospital cost, and length of hospital stay.
- The safety regarding port site cancer recurrence is comparable to open surgery.
- Long-term follow-up is essential to fully establish the efficacy of laparoscopic colon resection for colorectal cancer.
