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Hand-assisted laparoscopic colectomy compared with open colectomy in a nontertiary care setting
Raymond U Osarogiagbon1, Osa Ogbeide, Egunmwendia Ogbeide
1Division of Hematology/Medical Oncology, Department of Medicine, University of Tennessee Cancer Institute, Memphis 38104, USA. uyiosa@utcancer.com
Clinical Colorectal Cancer
|August 8, 2007
Summary
Hand-assisted laparoscopic colectomy (HALC) offers similar operating times to open colectomy but significantly reduces hospital stays. This minimally invasive approach provides equivalent or better oncologic outcomes for colon cancer patients.
Area of Science:
- Colorectal Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic colectomy provides oncologic resection comparable to open colectomy but with longer operating times.
- Hand-assisted laparoscopy (HALC) aims to combine laparoscopic benefits with reduced operative duration.
Purpose of the Study:
- To compare the intraoperative and postoperative outcomes of hand-assisted laparoscopic colectomy (HALC) versus open colectomy for colon tumors.
Main Methods:
- Retrospective review of consecutive patients undergoing HALC or open colectomy for colon tumors between April 2003 and September 2004.
- Exclusion of patients with rectal cancer and stage IV disease.
- Comparison of operative time, hospitalization duration, lymph node yield, and postoperative infection rates using the Mann-Whitney U test.
Main Results:
- Median operating room time was similar (139 minutes for HALC vs. 137 minutes for open colectomy; P = 0.94).
- Hospitalization duration was significantly shorter for HALC (6 days vs. 10 days; P = 0.007).
- HALC demonstrated equivalent or superior oncologic resection and pathologic staging, with a higher median lymph node yield (12 vs. 9; P = 0.043).
Conclusions:
- Hand-assisted laparoscopic colectomy is a feasible technique in non-tertiary care settings.
- HALC offers comparable surgical duration to open colectomy.
- HALC results in significantly shorter hospital stays and equivalent or superior oncologic outcomes.
